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Blood Loss Management. During every hip and knee replacement surgery, there is a certain amount of blood loss. There are several approaches to address the management of this blood loss that you should discuss with your orthopedic surgeon, including blood transfusions or PROCRIT treatment. Dr. Nessler uses every means he can to assure that you will not need to have any type of blood replacement or transfusion. To help us in determining your possible individual need for blood transfusions a blood test to check your hemoglobin will be drawn when you schedule your surgery. With the newer techniques most people with a normal blood count before surgery will not need to have a blood transfusion so he rarely will have anyone donate their blood for transfusion later. This is important because there are certain risks to you even when you receive your own blood back. Dr. Nessler's goal in surgical treatment is to minimize or eliminate as many risks to you as possible.
Blood Transfusion. Some patients who have a hip or knee replacement will require blood transfusion. This can be achieved by transfusing blood that you have donated prior to your surgery or by receiving blood from a donor.
Self Donation. If you are donating blood for your surgery, you will be asked to donate 1 to 2 units of your own blood within 35 days prior to your surgery date. This will involve scheduling an appointment with the blood bank of the hospital. Only one unit of blood can be donated at a time, so you may need to come in for two visits. The blood is then stored until your operation. Just a reminder, that this is rarely needed and as a general rule Dr. Nessler does not recommend this for patients having primary hip or knee surgery.
Donor Blood. If you are unable to donate blood, for whatever reason, donor blood may be used in your case, if necessary.donor blood can be donated by family or friends and directed to you or it can be obtained from the national blood supply. People have expressed some concern about blood transfusion because of the risk of transmitting diseases. Donor blood is carefully screened for communicable diseases. With the new technology, the risk of hepatitis and HIV infection is extremely low. To our knowledge, disease transmission through use of donated blood has never occurred in any of our patients..
Procrit®. Another approach to blood loss management is to treat patients with Procrit ® - a medication that works to increase the red blood cell supply before surgery. If you are a candidate for Procrit treatment, your blood will be tested to determine its hemoglobin (this is a measure of how much of your blood is made up of blood cells).If your hemoglobin is between 10 and 13 (g/dL), you can receive Procrit® treatment. This involves three to four injections (subcutaneous-under the skin) in once weekly doses (21, 14, and 4 days before surgery) plus a fourth dose on the day of surgery.You will also be asked to take iron supplements during this time. 
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