Greater increase in cytokine concentration after salvage with filtered whole blood than with washed red cells, but no difference in postoperative hemoglobin recovery.
BACKGROUND
Inflammatory mediators are released in association with intraoperative and postoperative salvage of blood. Whether these mediators (cytokines) participate in the modulation of erythropoiesis or not has been investigated.


METHODS
Twenty-seven patients who were to undergo total knee replacement surgery were randomly assigned to postoperative blood salvage with either filtered whole blood or washed red cells. Patients with postoperative blood loss <400 mL were considered a control group. The control group did not receive any transfusions. Plasma concentrations of the anaphylatoxin C3a, the C5b-9 terminal complement complex, and the cytokines interleukins 6 and 8, hemoglobin, reticulocytes, and red cell volume fraction in the patients were repeatedly analyzed before and after surgery.


RESULTS
Significantly increased concentrations of interleukin 6 appeared in all three groups, which was interpreted as a response to the surgical trauma. The increase was significantly greater in the group that received filtered whole blood after return of shed blood. The recovery of hemoglobin levels did not differ in the groups.


CONCLUSIONS
The transfusion of filtered whole blood leads to the formation of interleukin 6 in the circulation, but postoperative hemoglobin recovery was similar in all groups.
Avall
A
A
Department of Anesthesiology & Intensive Care, Sahlgrenska University Hospital, Göteborg, Sweden.
Hyllner
M
M
Bengtson
J P
JP
Carlsson
L
L
Bengtsson
A
A
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D001772:Blood Cell Count; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous / Q000379:methods*; D002469:Cell Separation / Q000379:methods; D015926:Complement C3a / Q000032:analysis; D015938:Complement Membrane Attack Complex / Q000032:analysis; D016207:Cytokines / Q000097:blood*; D017707:Erythrocyte Transfusion / Q000379:methods*; D005260:Female; D005374:Filtration; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage; D011184:Postoperative Period
D015938:Complement Membrane Attack Complex; D016207:Cytokines; D006454:Hemoglobins; D015850:Interleukin-6; D016209:Interleukin-8; D015926:Complement C3a