Impact of postoperative shed blood transfusion, with or without leucocyte reduction, on acute‐phase response to surgery for total knee replacement

Abstract

Postoperative blood salvage and return, with or without a LRF, after TKR does not present any clinically relevant side-effects and does not modify APR induced by surgery. These findings seem to confirm the clinical experience that postoperative USB return is safe and questions the beneficial effect of using LRF.

Post-traumatic immunosuppression is reversed by anti-coagulated salvaged blood transfusion: deductions from studying immune status after knee arthroplasty

“…S2a-d) were attributable to gene promoter polymorphisms, but we were unable to show that these differences contributed to PTI, as trends expressed as fold-changes were consistent within each patient [37]. Lack of correction for individual variations in studies by others may have reduced sensitivity of analyses [26][27][28]. Constituents of salvaged blood that were assumed to have originated from surgically induced necrotic and ischaemic tissues were called stable biomarkers, and these included S100 A8/A9, α-defensin, HSP-27, HSP-70, HSP-60 and IL-9.…”

“…Previous reports were either multi-centre studies of patients following diverse incidents of trauma [11] or studies using alternative blood collection procedures [26][27][28][33][34][35]. Major features of PTI included subnormal levels of the proinflammatory cytokines IL-1β, IL-2, IL-17A, IFN-γ and TNF-α, a picture that was reversed dramatically by salvaged blood.…”

“…+ phenotype using flow cytometry and suppression of immune status [26][27][28]. Our NKp cell subset would have been negative for CD16, and only measurable by limiting dilutions analysis at levels well below detection by routine flow cytometry [29][30][31].…”

Blood Transfusion in Knee Arthroplasty

“…The followed protocol in blood retrieval is the reinfusion of the collected blood within 6 first hours (Dalen et al, 1995). Using blood from postoperative drainage (blood retrieval) in knee arthroplasty does not show important complications (Groh et al, 1990;Sinardi et al, 2005;Wojan et al, 2005), neither inflammatory cell response increase ( Altinel et al, 2006;Munoz et al, 2005b;Munoz et al, 2006). According to different studies there are no statistically significant differences within the studied parameters, except for IL-6, which could increase febrile reactions ( Handel et al, 2006;Kristiansson et al, 1995).…”

“…This blood includes too activated coagulation factors and fibrinogen degradation products, which could be the cause of coagulopathies. However, no significant increase in bleeding has been found, neither coagulation disorders clinically expressive There are no differences in perioperative inflammatory mediators levels between patients receiving unwashed retrieved blood from those who do not get it (Munoz et al, 2005b). Fat particles content, which is the main cause of fat embolism and respiratory distress syndrome, is controlled using a filter between collection and reinfusion container, and dismissing the last 80-100 cc.…”