Release of interleukin-10 by reinfusion of salvaged blood after knee arthroplasty.
OBJECTIVE
To determine whether the method of the autotransfusion in association with knee arthroplasty leads to differences in anti-inflammatory cytokines in the patient's circulation.


METHODS
Prospective study in a university hospital.


METHODS
Twenty-one patients undergoing knee arthroplasty were randomized into two groups assigned to postoperative blood salvage. Seven patients received postoperatively filtered salvaged blood, and seven received centrifuged and washed salvaged blood. Patients with postoperative blood loss less than 400 ml (n=7) did not receive any transfusion.


RESULTS
Plasma levels of interleukin (IL) 1beta, IL-4, and IL-10 and of polymorphonuclear leukocyte elastase were measured by enzyme-linked immunosorbent assay. The plasma concentration of IL-10 was elevated after reinfusion of salvaged blood in all groups 1 day after surgery (p<0.05). Plasma IL-6, IL-10, and PMN elastase was higher (p<0.01) in all groups 1 day after surgery than preoperatively. There were significantly higher plasma levels 1 min after retransfusion of IL-6 (p<0.01) and IL-10 (p<0.05) in patients receiving filtered blood than in those receiving centrifuged and washed salvaged blood.


CONCLUSIONS
Total knee arthroplasty results in the release of interleukin-10. Transfusion of filtered salvaged blood leads to higher levels of cytokines IL-6 and IL-10 than after transfusion of washed and centrifuged salvaged blood.
Tylman
M
M
Department of Anesthesiology and Intensive Care, Sahlgrenska University Hospital Ostra, 41685 Gothenburg, Sweden. tylman@mailer.mednet.gu.se
Bengtson
J P
JP
Avall
A
A
Hyllner
M
M
Bengtsson
A
A
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D001804:Blood Transfusion, Autologous; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D019272:Leukocyte Elastase / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors
D016207:Cytokines; D015850:Interleukin-6; D016753:Interleukin-10; D019272:Leukocyte Elastase