Erythrozytenqualität nach maschineller Autotransfusion und Wundblutdrainage

Biedler, A.; Wilhelm, Wolfram

doi:10.1007/s001010170006

Cited by 8 publications

(5 citation statements)

References 28 publications

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“…Statt dessen sollten wir daran arbeiten, diese weitverbreitete Methode in seiner Qualität und sicheren Anwendung noch weiter zu verbessern. [1]. Tatsächlich sind die meisten der potenten Mediatoren, die aus Hämostaseolo-gie, Immunologie und Zellbiologie bekannt geworden sind, in der aktivierten Zytolyse-Suppe "Wundblut" zu finden.Wollen wir die gleichen Mediatoren zur Erklärung der schlimmsten Komplikationen unserer Patienten (z.B.…”

Section: "Die Qualität Dieses Blutes Ist Stark Wechselnd Und Gewöhnliunclassified

Direktretransfusion von Wundblut

Seiler¹,

Biedler²

2003

Der Anaesthesist

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Section: "Die Qualität Dieses Blutes Ist Stark Wechselnd Und Gewöhnliunclassified

Direktretransfusion von Wundblut

Seiler¹,

Biedler²

2003

Der Anaesthesist

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“…The data from studies that determined cytokines (IL-6, TNF, IL-10), surface receptors of leukocytes (CD11b, CD18), complement factors (C4d, factor B, C3a, SC5b-9) and lipid mediators (PAF, LTB4) in salvaged washed wound blood are also not uniform [1]. It is difficult to interpret all these results, because the various studies differ strongly in design (transfusion of stored blood products, cardiopulmonary bypass (CPB), anesthesia and volume regime …).…”

Section: Activation Markers In the Ibs Concentrate Supernatantmentioning

confidence: 99%

“…When using IBS devices, undesired components such as anticoagulant solution, leukocytes, thrombocytes and plasma are eliminated passively by means of centrifugation (sedimentation of the blood cells corresponding to the density) and the subsequent washing process. Leukocytes are not eliminated completely, and, depending on the type of IBS device used and the hematocrit content of the salvaged blood, leukocyte concentrations of 2-14 × 10 9 /l have been ascertained [1]. Although clinical experience has shown IBS safety to be excellent, concern persists that the leukocytes contained in the erythrocyte concentrate might be activated, thus being detrimental for the recipient.…”

Section: Introductionmentioning

confidence: 99%

Leukocyte Activation by means of Intraoperative Blood Salvage

Innerhofer¹,

Wiedermann²

2002

Transfus Med Hemother

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Although clinical experience has shown the safety of intraoperative blood salvage (IBS) to be excellent, the activation of polymorphonuclear leukocytes (PMNL) induced by the preparation process is discussed as a clinically relevant and undesired side effect. Animal experiments and a very few case reports associate the symptoms, namely general edema, ARDS and coagulopathy (salvaged blood syndrome), with the activation of PMNL by IBS. The results of studies investigating concentrations of cytokines, lipid mediators and complement factors show that these undesired substances are reduced by the centrifugation and washing process to an extent considered adequate by most publications. However, only very few data are available on functional responses of PMNL in the IBS concentrate. Excess activation of PMNL by unphysiological priming can be assessed by determining the production of O2 radicals (respiratory burst). In addition, chemotaxis measurements provide information on the migratory capacity of PMNL, which is also changed by priming. Functional studies demonstrate a reduced to slightly increased respiratory burst in PMNL of the IBS concentrate as compared with measurements in native patient blood as well as a reduced migratory capacity. In agreement with the excellent clinical experience concerning the incidence of serious side effects following IBS, these results show that retransfusion of IBS concentrates containing moderately activated PMNL should not be deleterious for the recipient.

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“…Therefore, it is obvious that blood salvaged intraoperatively has to be washed to get rid of proinflammatory substances and activated factors of the coagulation system [2]. The presence of these substances in unwashed salvaged blood is likely to be the cause for the alarmingly high rate of unwanted effects observed after the retransfusion of such blood [2]. Furthermore, it has to be considered that intraoperative blood salvage is especially effective if the patient is able to tolerate a high perioperative hematocrit difference [3].…”

Section: Introductionmentioning

confidence: 99%

“…It is mandatory from the view of transfusion medicine that the quality of autologous blood products has to be similar to the quality of homologous blood. Therefore, it is obvious that blood salvaged intraoperatively has to be washed to get rid of proinflammatory substances and activated factors of the coagulation system [2]. The presence of these substances in unwashed salvaged blood is likely to be the cause for the alarmingly high rate of unwanted effects observed after the retransfusion of such blood [2].…”

Section: Introductionmentioning

confidence: 99%

Blood Irradiation for Intraoperative Autotransfusion in Cancer Surgery – the View of Transfusion Medicine

Weisbach¹,

Eckstein²

2004

Transfus Med Hemother

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At present, it is uncertain whether intraoperative autotransfusion of irradiated shed blood in cancer surgery is advantageous for the patient compared to homologous blood transfusion. The answer to this question fundamentally depends on the respective figures for the risks of homologous blood. The remaining importance of transfusion-associated immunomodulation, which is of special interest in cancer surgery, is completely unclear after the introduction of prestorage leukodepletion of cellular blood components in Germany. The quality of intraoperatively salvaged and irradiated blood is superior to homologous as well as autologous red blood cell (RBC) concentrates or whole blood which have been stored for 1 week or longer. However, it is unclear whether this is of clinical relevance. Prospective, randomized clinical studies are needed to ascertain the promising benefits of intraoperative autotransfusion of irradiated shed blood in cancer surgery.

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Erythrozytenqualität nach maschineller Autotransfusion und Wundblutdrainage

Cited by 8 publications

References 28 publications

Direktretransfusion von Wundblut

Direktretransfusion von Wundblut

Leukocyte Activation by means of Intraoperative Blood Salvage

Blood Irradiation for Intraoperative Autotransfusion in Cancer Surgery – the View of Transfusion Medicine

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