Should antifibrinolytics be used in patients undergoing total joint replacements?

Abstract

In the preoperative testing clinic, I meet a thin elderly woman who is scheduled to have a revision of her left total hip replacement. I call her into my office, and she walks slowly with a cane. A quiet "unh" punctuates each step she takes. The 3-m distance never seemed so far. She had a history of breast cancer in remission after a mastectomy and chemotherapy 5 years ago. She also has thalassemia trait. In her previous surgeries, she required blood transfusions. I look over the blood test results and note that her hemoglobin is 11 gm/dl and hematocrit 34 %. Her blood type and screen shows the presence of antibodies to the surface antigens of her red blood cells.