Background: Retransfusion of postoperatively drained wound blood may be associated with adverse immune effects induced by many mediators present in unwashed filtered blood.
Study design and methods: In this randomized trial, the hypothesis that a washing procedure alters the course of markers of immune and inflammatory responses after retransfusion of blood collected from patients after endoprosthetic surgery is tested. Mean volume of blood reinfused was 363 +/- 173 mL in Group A and 352 +/- 180 mL in Group B. Five hours postoperatively patients either received washed (Group A) or unwashed (Group B) blood collected during the postoperative period. Circulating cytokines (tumor necrosis factor [TNF]-alpha, interleukin [IL]-6, IL-8, IL-10, monocyte chemoattractant protein [MCP]-1) and lipopolysaccharide (LPS)-stimulated TNF-alpha secretion were measured at several time points pre- and postoperatively.
Results: IL-6 and IL-8 slightly increased immediately after retransfusion in both groups (by 48 +/- 37 and 5 +/- 2 pg/mL, respectively, in Group A; by 74 +/- 60 and 17 +/- 13 pg/mL in Group B). IL-10 and MCP-1 were unaltered and both circulating TNF-alpha and LPS stimulated capacity in TNF-alpha secretion decreased (by 5 +/- 13 and 1 +/- 31 pg/mL, respectively, in Group A; by 3 +/- 14 and 29 +/- 39 pg/mL in Group B), independent from a washing procedure.
Conclusion: For small reinfusion volumes a washing procedure does not alter the ex vivo capacity of LPS induced TNF-alpha secretion and the selected cytokine profile after retransfusion of postoperatively drained and filtered blood.