Complement split products and pro-inflammatory cytokines in salvaged blood after hip and knee arthroplasty.
OBJECTIVE
To determine whether salvaged autologous blood collected postoperatively contains complement split products (SC5b-9), and pro-inflammatory cytokines (IL-6 and IL-8) and whether there are any differences between blood collected during hip or knee surgery.


METHODS
Fifty-eight consecutive patients undergoing hip or knee replacement surgery were studied. Thirty-eight had postoperative bleeding large enough to require infusion of salvaged blood. The salvaged blood was filtered during collection through a 200 microm filter and before infusion a 40 microm filter was used. Samples for complement and cytokine determinations were drawn from the circulation and from the collected blood.


RESULTS
High concentrations of SC5b-9, IL-6, and IL-8 were found in salvaged blood. The concentrations were higher than in the circulation (P < 0.05). The circulating concentrations of IL-6 and IL-8 were increased 60 min and 12-18 hr after transfusion. There were no differences regarding SC5b-9, IL-6, and IL-8 in the blood collected after hip or knee surgery.


CONCLUSIONS
Blood collected from a surgical wound contains large concentrations of inflammatory mediators. There were no differences between blood collected during hip or knee surgery.
Andersson
I
I
Department of Anesthesiology & Intensive Care, East Hospital/Sahlgrenska University Hospital, Gothenburg, Sweden. irene_maria.andersson@sahlgrenska.se
Tylman
M
M
Bengtson
J P
JP
Bengtsson
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D001772:Blood Cell Count; D001804:Blood Transfusion, Autologous; D015938:Complement Membrane Attack Complex; D003165:Complement System Proteins; D016207:Cytokines / Q000097:blood*; D005260:Female; D005374:Filtration; D006023:Glycoproteins / Q000097:blood*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D019272:Leukocyte Elastase / Q000097:blood; D008297:Male; D008875:Middle Aged
D015938:Complement Membrane Attack Complex; D016207:Cytokines; D006023:Glycoproteins; D006454:Hemoglobins; D015850:Interleukin-6; D016209:Interleukin-8; C047610:SC5b-9 protein complex; D003165:Complement System Proteins; D019272:Leukocyte Elastase