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Other concerns associated with allogeneic blood transfusion include the quality of stored red cell concentrates, the cost of provision of blood and the predicted local demographics, which mean that fewer donors will need to support a greater number of recipients. In view of the multiple challenges associated with allogeneic blood transfusion and its provision, we developed practical management recommendations for perioperative bleeding in joint replacement surgery, based on available evidence and expert consensus opinion, that aim to promote a new, responsible approach to transfusion management. Key recommendations are as follows. Patients' medical health, including haemoglobin and iron levels, needs to be evaluated and optimized preoperatively. Anticoagulant and antiplatelet therapy should be stopped if possible, unless indicated for secondary cardiovascular prevention or coronary stent patency, in which case careful consideration is required. If substantial blood loss is anticipated, intraoperative management with antifibrinolytic agents is recommended for bleeding prophylaxis. Normothermia should be maintained. Pharmacological and non\u2010pharmacological measures are recommended for post\u2010operative thromboprophylaxis. A blood management programme should be instituted for haemodynamically stable patients.<\/jats:p>","DOI":"10.1111\/ans.12000","type":"journal-article","created":{"date-parts":[[2012,11,1]],"date-time":"2012-11-01T09:37:38Z","timestamp":1351762658000},"page":"222-229","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Practical recommendations for patient blood management and the reduction of perioperative transfusion in joint replacement surgery"],"prefix":"10.1111","volume":"83","author":[{"given":"Warwick","family":"Bruce","sequence":"first","affiliation":[{"name":"Concord Repatriation General Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Campbell","sequence":"additional","affiliation":[{"name":"Wakefield Orthopaedic Clinic  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Daly","sequence":"additional","affiliation":[{"name":"Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Isbister","sequence":"additional","affiliation":[{"name":"Royal North Shore Hospital and Sydney Medical School  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-201003000-00002"},{"key":"e_1_2_7_3_1","unstructured":"Better Safer Transfusion (BeST) program.Blood management in elective orthopaedic sugery: 2005\u201006 hospital data. 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