ABSTRACT
BACKGROUND AND OBJECTIVES: Transfusion-induced immunomodulation by autologous blood is probably related to the buffy coat. Hence, in the present study, phagocytotic and oxidation activities of peripheral blood cells were investigated in hip arthroplasty patients exposed to autologous blood. MATERIALS AND METHODS: Blood from 60 autologous donors was allocated at random to storage as whole blood (WB) or as buffy coat-poor packed red cells and fresh-frozen plasma (RCP). Phagocytotic and oxidation activities of neutrophils and monocytes, incidence of infections and length of hospital stay were compared among the groups of transfused (WB and RCP) and non-transfused (NT) patients. RESULTS: Phagocytotic activities of neutrophils and monocytes were not significantly different among the WB, RCP and NT groups. CONCLUSION: In the perioperative setting, a specific cellular immune response to autologous transfusion is not detectable.
Subject(s)
Arthroplasty, Replacement, Hip/methods , Blood Transfusion, Autologous/adverse effects , Immunity, Cellular/immunology , Aged , Blood Preservation/methods , Blood Transfusion, Autologous/methods , Cohort Studies , Cryopreservation/methods , Erythrocyte Transfusion/adverse effects , Erythrocyte Transfusion/methods , Female , Humans , Infections/etiology , Length of Stay , Male , Middle Aged , Monocytes/immunology , Neutrophils/immunology , Neutrophils/metabolism , Phagocytosis , Respiratory Burst , Time FactorsABSTRACT
BACKGROUND AND OBJECTIVES: The immune response to the transfused autologous buffy coat content in whole blood has, to date, not been studied in detail. SUBJECTS AND METHODS: Patients undergoing hip arthroplasty were studied according to whether they received autologous whole blood (WB) (n = 30), autologous fresh-frozen plasma and buffy coat-poor red cells (RC) (n = 40), or no transfusion (NT) (n = 27). Plasma levels of tumour necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and complement SC5b-9 were analysed by enzyme-linked immunosorbent assay (ELISA) 7 days after surgery. RESULTS: There were no significant between-group differences regarding the time course of TNF-alpha, IL-6 and complement SC5b-9 plasma level changes, the infection rate, or the length of hospital stay. CONCLUSION: In comparison to the impact of surgery on cytokine and complement levels, the transfusion of autologous buffy coat is not relevant.
Subject(s)
Antibody Formation/drug effects , Arthroplasty, Replacement, Hip/methods , Blood Transfusion, Autologous/adverse effects , Adult , Aged , Blood Component Transfusion/adverse effects , Blood Component Transfusion/methods , Blood Preservation/methods , Blood Transfusion, Autologous/methods , Cohort Studies , Complement Membrane Attack Complex , Complement System Proteins/analysis , Complement System Proteins/immunology , Complement System Proteins/pharmacology , Cryopreservation/methods , Female , Glycoproteins/analysis , Glycoproteins/immunology , Glycoproteins/pharmacology , Humans , Infections/etiology , Inflammation Mediators/analysis , Inflammation Mediators/immunology , Inflammation Mediators/pharmacology , Interleukin-6/analysis , Interleukin-6/immunology , Interleukin-6/pharmacology , Length of Stay , Male , Middle Aged , Time Factors , Tumor Necrosis Factor-alpha/analysis , Tumor Necrosis Factor-alpha/immunology , Tumor Necrosis Factor-alpha/pharmacologyABSTRACT
To reduce allogeneic blood transfusion requirements during extracorporeal membrane oxygenation (ECMO) we evaluated an autotransfusion device which processes and retransfuses erythrocytes of changed ECMO-systems. We studied 10 elective changes of ECMO-systems in 7 patients. Hemoglobin levels, the amount of retransfused autologous blood and of transfused allogeneic packed red blood cell units were documented within 48 h after the system change and compared to the measurements obtained from former ECMO-system changes without using any autotransfusion device. We determined the Horrowitz-index, Interleukin 6, 10, TNF-alpha and endothelin-I concentrations and coagulation parameters during the 48 hours after system change to study the compatibility of this procedure. Allogeneic blood transfusion was reduced from 7 to 2 units of packed red cells using the autotransfusion device. Additionally, no hints of any harmful side effects in these patients was observed.