Blood transfusion and cytokines' changes in total knee replacement.
BACKGROUND
The aim of this prospective comparative study was to evaluate the serum levels of different cytokines and the frequency of adverse reactions and wound infections in patients who underwent total knee replacement (TKR) and were not transfused or received either allogeneic blood transfusion or postoperative auto-transfusion (PAT) with unwashed shed blood.


METHODS
A total of 248 patients were categorized into three groups; in Group 0 (n 85) patients received no blood transfusion, in Group 1 (n 92) patients received PAT and in Group 2 (n 71) patients received allogeneic blood transfusion. Patient's demographic and clinical data including age, gender, body mass index, preoperative haemoglobin value, adverse reactions and complications were documented. The serum levels of IL-1b, IL-6, IL-8, IL-10 and TNF were measured preoperatively, and on the first, third and fifth postoperative day. A statistical analysis of the results was performed.


RESULTS
A significant elevation of cytokine values were observed during the first five postoperative days in patients who received blood transfusion after TKR. Adverse reactions (chills and pyrexia) were also more common in patients who received blood transfusion, whereas superficial infections were more common in patients who received allogeneic blood transfusion.


CONCLUSIONS
The immunological status-as expressed by the measured cytokine levels-is altered in patients receiving blood transfusion compared to patients receiving no blood transfusion during the first five postoperative days. PAT is preferable to allogeneic blood transfusion in terms of the rate of adverse reactions and superficial wound infections.
Medical School, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece. drosos@otenet.gr
Georgios I
GI
Drosos
Konstantinos S
KS
Blatsoukas
Athanasios
A
Ververidis
Grigorios
G
Tripsianis
Pelagia
P
Chloropoulou
Christos
C
Iatrou
Konstantinos
K
Kazakos
Dionisios-Alexandros
DA
Verettas
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D001803:Blood Transfusion; D016207:Cytokines / Q000097:blood* / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000097:blood / Q000276:immunology* / Q000601:surgery; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000209:etiology
D016207:Cytokines