title: Determination of eicosanoid and cytokine production in salvaged blood, stored red blood cell concentrates, and whole blood.
abstract: OBJECTIVE
  To determine the production of the eicosanoids prostaglandin 2 (PGE2) and thromboxane 2 (TxB2) and the cytokines interleukin 1 beta (IL-1-beta) and interleukin 6 (IL-6) in whole blood (WB), unfiltered red blood cell (RBC), and filtered RBC concentrates, and salvaged blood.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  University hospital of Erlangen.
  
  
  METHODS
  32 healthy volunteers and 14 ASA physical status I, II, and III radical prostatectomy patients (mean age 65 yrs).
  
  
  METHODS
  Sixteen WB units and 16 RBC units (divided into 16 filtered and unfiltered units each) were taken from 32 volunteers. Fourteen salvaged RBC units were obtained from the 14 radical prostatectomy patients. Sixteen WB units were stored for 35 days. From the 16 WB donations, RBC concentrates (PAGGS-M) were prepared. The RBC concentrates were halved, one half had its leukocytes removed at day 0; both halves were stored for 49 days. Salvaged blood (n = 14) was stored up to 2 hours during surgery and then retransfused.
  
  
  RESULTS
  Immediately at the start of the study, in all blood units (WB, RBC filtered, and RBC unfiltered units) at days 0 and 21, and at the end of the storage period (WB: 35 days, RBC concentrates: 49 days) and in the salvaged RBC units, the following parameters were measured: PGE2, TxB2, IL-1-beta, IL-6, hematocrit, platelet number, leukocytes, blood volume, and hemoglobin. During storage, different levels of PGE2, TxB2, IL-1-beta, IL-6 for WB, filtered RBC concentrates, and unfiltered RBCs were found. The higher levels of PGE2, TxB2, IL-1-beta, and IL-6 were found in the WB and RBC salvaged units than the filtered RBCs or unfiltered RBC units. There was no statistically significant difference between WB and salvaged RBCs. Higher levels of leukocytes and platelets were found in WB units and salvaged RBCs as compared to filtered or unfiltered RBCs.
  
  
  CONCLUSIONS
  The eicosanoid and cytokine levels in the salvaged, filtered RBC, unfiltered RBC, and WB units stayed within physiological limits, suggesting that these levels do not contribute to the risk of nonhemolytic, immunomodulated transfusion reactions, even in massive transfusions.
authors.affiliation: Department of Anesthesiology, University of Erlangen-Nuremburg, Erlangen, Germany. jacobi@anaesthesiologie.med.uni-erlangen.de
authors.forename: K E
authors.initials: KE
authors.lastname: Jacobi
authors.forename: C
authors.initials: C
authors.lastname: Wanke
authors.forename: A
authors.initials: A
authors.lastname: Jacobi
authors.forename: V
authors.initials: V
authors.lastname: Weisbach
authors.forename: T M
authors.initials: TM
authors.lastname: Hemmerling
mesh_terms: D000276:Adjuvants, Immunologic / Q000097:blood; D000368:Aged; D001804:Blood Transfusion, Autologous; D001810:Blood Volume / Q000502:physiology; D015232:Dinoprostone / Q000097:blood*; D004912:Erythrocytes / Q000378:metabolism* / Q000473:pathology; D005374:Filtration; D005500:Follow-Up Studies; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007375:Interleukin-1 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D007958:Leukocyte Count; D008297:Male; D010976:Platelet Count; D011446:Prospective Studies; D011468:Prostatectomy; D012307:Risk Factors; D013929:Thromboxane B2 / Q000097:blood*
chemical_list: D000276:Adjuvants, Immunologic; D006454:Hemoglobins; D007375:Interleukin-1; D015850:Interleukin-6; D013929:Thromboxane B2; D015232:Dinoprostone