Mayer-Rollnik S, Harms C, Bernasconi L, et al. - Given postoperative autologous retransfusion of drainage blood might decrease the transfusion of red blood cell concentrates following major orthopaedic surgery, researchers mainly assessed the effectiveness of a blood collection and retransfusion system in this combined retrospective and prospective cohort analysis. They also looked at the safety issues as well as the quality of the drainage blood collected. There were 216 and 46 patients in retrospective and prospective cohort, respectively. The participants had undergone elective hip or knee replacement. Retransfused patients vs those without retransfusion exhibited a rise in postoperative haemoglobin level by 5 g dl⁻¹. Thirteen retransfused patients (26%) experienced mild adverse transfusion reactions. Massively high levels of myeloperoxidase and IL-6 in the drainage blood was revealed in laboratory analyses for the second prospective part, however, the detected C-reactive protein and procalcitonin levels were within normal ranges at both time points. Based on the findings, the effectiveness of postoperative autotransfusion as a component of a patient blood management programme is doubtful. Additionally, safety concerns were raised by clear signs of inflammatory reactions and coagulation activation.