Suda Yoshihito, Nakano Naoki, Takashima Yoshinori, Tsubosaka Masanori, Kamenaga Tomoyuki, Kuroda Yuichi, Ishida Kazunari, Hayashi Shinya, Kuroda Ryosuke, Matsumoto Tomoyuki
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan.
Department of Orthopaedic Surgery, Kobe Kaisei Hospital, 3-11-15 Shinoharakita-Cho, Nada-Ku, Kobe, 657-0068, Japan.
Knee Surg Relat Res. 2025 Jul 25;37(1):32. doi: 10.1186/s43019-025-00284-3.
The aim of this study was to compare total perioperative blood loss in patients undergoing total knee arthroplasty (TKA) in different ABO blood types.
This study was approved by the Institutional Review Board of our hospital (IRB No. 1510) on 2 February 2015. A total of 260 knees undergoing unilateral primary cemented cruciate-retaining TKA for knee osteoarthritis were retrospectively registered. Perioperative total blood loss was calculated for each blood types based on the change in hematocrit from pre- to postoperative day 7, preoperative height and weight. Differences in blood loss among the four ABO blood types were assessed. The association between blood type (O versus others) and total blood loss was further evaluated after adjusting for baseline characteristics through inverse probability of treatment weighting (IPTW).
The study population was divided based on the ABO blood type: type O, 87; type A, 82; type B, 54; and type AB, 37. The mean total blood loss was 829 ± 370 ml for type O, 702 ± 384 ml for type A, 574 ± 361 ml for type B, and 528 ± 282 ml for type AB. Patients with blood Type O had significantly higher blood loss than all other blood types. After IPTW adjustment, mean total blood loss remained higher in type O (790 ± 370 ml) compared to other blood types (613 ± 364 ml).
These findings suggest that blood type O may be associated with increased perioperative blood loss in TKA.
本研究旨在比较不同ABO血型的全膝关节置换术（TKA）患者围手术期的总失血量。
本研究于2015年2月2日获得我院机构审查委员会批准（IRB编号：1510）。回顾性登记了260例因膝关节骨关节炎接受单侧初次骨水泥固定保留交叉韧带TKA的膝关节病例。根据术前至术后第7天血细胞比容的变化、术前身高和体重，计算每种血型的围手术期总失血量。评估四种ABO血型之间失血量的差异。通过治疗权重逆概率（IPTW）调整基线特征后，进一步评估血型（O型与其他血型）与总失血量之间的关联。
研究人群根据ABO血型进行划分：O型87例；A型82例；B型54例；AB型37例。O型的平均总失血量为829±370ml，A型为702±384ml，B型为574±361ml，AB型为528±282ml。O型血患者的失血量明显高于所有其他血型。经过IPTW调整后，O型血患者的平均总失血量（790±370ml）仍高于其他血型（613±364ml）。
这些发现表明，O型血可能与TKA围手术期失血量增加有关。
