Plasma levels of eicosanoids after transfusion of intraoperatively salvaged blood.
BACKGROUND
The interest in autologous red blood cell salvage is increasing rapidly, but it is well known that platelets and white cells are activated during cell washing. Therefore, we aimed to determine whether or not eicosanoids transfused together with the salvaged blood are responsible for nonhemolytic immunological transfusion reactions.


METHODS
In 11 patients who underwent radical prostatectomy we studied the release of eicosanoids, prostaglandin E(2) (PGE(2)) and thromboxane B(2) (TxB(2)), in association with reinfusion of intraoperatively salvaged blood. Blood samples were taken before operation, on days 1 and 3 after operation and before and after cell washing.


RESULTS
There was a twofold increase in PGE(2) and a twentyfold increase in TxB(2) in the unwashed salvaged blood. Washing caused a reduction in eicosanoid plasma levels of up to 95%, but a significantly lower level in relation to its corresponding preoperative value was only found for PGE(2). After transfusion of an average of 420 ml RBC sediment from washed blood, the patients' plasma concentrations of PGE(2) and TxB(2) on the 1st and 3rd postoperative day did not significantly differ compared to baseline values.


CONCLUSIONS
Our data support the notion that RBC sediment from 'salvaged' and washed autologous blood contains increased amounts of PGE(2) and TxB(2). It remains, however, questionable if these passively infused eicosanoids become biologically active. According to our study, the PGE(2) and TxB(2) transfused are apparently not responsible for nonhemolytic immunological transfusion reactions.
Jacobi
K
K
Klinik für Anästhesiologie, Chirurgische Klinik mit Poliklinik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland. jacobi@anaesthesiologie.med.uni_erlangen.de
Walther
A
A
Lörler
H
H
Neidhardt
B
B
D000368:Aged; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous / Q000592:standards; D015232:Dinoprostone / Q000097:blood / Q000378:metabolism; D015777:Eicosanoids / Q000097:blood* / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D013929:Thromboxane B2 / Q000097:blood / Q000378:metabolism
D015777:Eicosanoids; D013929:Thromboxane B2; D015232:Dinoprostone