Post-operative unwashed shed blood transfusion does not modify the cellular immune response to surgery for total knee replacement.
Acta Anaesthesiol Scand
; 50(4): 443-50, 2006 Apr.
Article
em En
| MEDLINE
| ID: mdl-16548856
ABSTRACT
BACKGROUND:
In patients undergoing total knee replacement (TKR), most blood loss occurs post-operatively, and the return of unwashed filtered shed blood (USB) from post-operative drainage may represent an alternative to allogeneic blood transfusion (ABT). We evaluated the impact of USB return on the cellular immune response (CIR) after TKR. PATIENTS ANDMETHODS:
Forty TKR patients, intended to receive post-operative USB, entered the study. Blood samples were obtained before and 6 h, 24 h, 72 h and 7 days after surgery, and from USB, after it had been passed through a 40-microm filter. Full blood cell counts, lymphocyte subsets and immunoglobulins (IgA, IgG, IgM) were measured in all samples. A set of clinical data was collected from each patient.RESULTS:
Twenty-four of the 25 patients received a mean of 1.2 USB units and did not need additional ABT (USB group). Twelve of the 15 remaining patients who received neither USB nor ABT served as a control group for the post-operative CIR study. All patients showed a post-operative decrease in T-cell and natural killer (NK) cell counts, but not B-cell counts, and there were no significant differences between the groups with regard to CIR parameters, post-operative infection or hospital stay.CONCLUSIONS:
Post-operative salvage and return of USB after TKR does not seem to increase the post-operative infection rate or hospital stay, and does not modify CIR induced by surgery. These findings add to the clinical experience that post-operative USB return, as a source of autologous blood, is safe, and questions the beneficial effect of blood washing.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transfusão de Sangue Autóloga
/
Perda Sanguínea Cirúrgica
/
Artroplastia do Joelho
/
Imunidade Celular
Limite:
Aged
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Acta Anaesthesiol Scand
Ano de publicação:
2006
Tipo de documento:
Article