title: Difference in autologous blood transfusion-induced inflammatory responses between acute normovolemic hemodilution and preoperative donation.
abstract: OBJECTIVE
  The inflammatory response triggered by transfusion is implicated in the pathophysiology of transfusion-related immunomodulation. The authors hypothesized that two distinctive autotransfusion methods, acute normovolemic hemodilution (ANH) and preoperative donation (PD), have different influences on both inflammatory mediator generation during storage and the inflammatory response after a transfusion. The purpose of this study was to compare the plasma concentrations of neutrophil elastase (NE), interleukin (IL)-6, IL-8, and IL-10 in patients who underwent either of these two autologous transfusion methods.
  
  
  METHODS
  With institutional review board approval, the plasma concentrations of the above inflammatory mediators were determined in 23 patients with ANH and 8 patients with PD at the following time points: after anesthetic induction, at the end of the operation, and the morning of postoperative day 1. The concentrations of these inflammatory mediators were also measured in the donated blood obtained by either ANH or PD before retransfusion.
  
  
  RESULTS
  The mean storage durations were 3.7 h and 6.1 days for ANH and PD, respectively. Higher concentrations of NE and IL-10 were detected in the PD blood than in the ANH blood. Long duration of storage and/or low temperature may have been responsible for the increased NE and IL-10 concentrations in the PD blood. However, the difference between the two groups in the extent of increased plasma concentrations of these inflammatory mediators was not statistically significant.
  
  
  CONCLUSIONS
  Inflammatory mediators were significantly increased in PD blood during storage compared to the blood obtained by ANH. However, their effects on the inflammatory response elicited in the recipients were not significantly different.
authors.affiliation: Department of Anesthesiology, Keio University, Tokyo, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kotake
authors.forename: Michiko
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Midori
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Takashige
authors.initials: T
authors.lastname: Yamada
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Nagata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Morisaki
authors.forename: Junzo
authors.initials: J
authors.lastname: Takeda
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous / Q000009:adverse effects*; D001810:Blood Volume / Q000502:physiology; D005260:Female; D006438:Hemodilution / Q000009:adverse effects*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000209:etiology* / Q000473:pathology*; D016753:Interleukin-10 / Q000096:biosynthesis; D015850:Interleukin-6 / Q000096:biosynthesis; D016209:Interleukin-8 / Q000096:biosynthesis; D007958:Leukocyte Count; D019272:Leukocyte Elastase / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D011446:Prospective Studies
chemical_list: D006454:Hemoglobins; D015850:Interleukin-6; D016209:Interleukin-8; D016753:Interleukin-10; D019272:Leukocyte Elastase