In five studies comparing different forms of storage of autologous
blood the allogenic transfusion rate, humoral and cellular immune
parameters and the postoperative infection rate were investigated.
In a prospective, randomized study 21 volunteers donated one unit
of blood. Retransfusion of stored autologous whole blood, but not
of autologous packed red cells and fresh frozen plasma, induced a
limited response of the immune system. Four prospective, randomized,
partially or totally blinded studies investigating autologous donation
in primary hip arthroplasty were carried out: In the first study
including 94 patients, in which autologous blood was stored as
whole blood, leukocyte-depleted whole blood or as blood components,
the allogenic transfusion rates were compared. The type of
storage of autologous blood did not influence homologous transfusion
requirements. In a second study dealing with humoral immune
factors, 97 patients were allocated at random to two groups. In one
group, the autologous donation was stored as whole blood, in the
other group the donation was separated into blood components before
storage. With respect to the parameters studied, there were no
significant differences between patients transfused with whole
blood and those transfused with blood components. Moreover,
these values also did not differ from those of patients not transfused.
In a third study, the phagocytosis and respiratory burst activity
of neutrophil granulocytes and of monocytes was measured in
58 patients who were randomly allocated to two groups as in the
previous study. Neither the time course of phagocytosis nor that of
respiratory burst activity showed a significant difference between
both groups. In a fourth multicenter study, 953 patients were allocated
to either of two groups. The first group of patients received
autologous blood stored as whole blood, in the second group
leukocyte depletion was done before storage. When comparing the
outcomes of both groups, it could be shown that leukocyte depletion
of autologous whole blood did not reduce the number of postoperative
infections in primary hip surgery. It is therefore concluded
that neither leukocyte depletion nor blood component separation
is mandatory when using autologous predeposit in primary hip
arthroplasty.