{"id":143,"date":"2006-04-01T00:00:01","date_gmt":"2006-04-01T00:00:01","guid":{"rendered":"https:\/\/awge.doctime.es\/?p=143"},"modified":"2016-05-24T08:24:29","modified_gmt":"2016-05-24T06:24:29","slug":"awge-258","status":"publish","type":"post","link":"https:\/\/awge.doctime.es\/index.php\/2006\/04\/01\/awge-258\/","title":{"rendered":"Post-operative unwashed shed blood transfusion does not modify the cellular immune response to surgery for total knee replacement."},"content":{"rendered":"

Acta Anesthesiol Sca
\nMunoz M, Cobos A, Campos A, Ariza D, Munoz E, Gomez A
\nAcceso al enlace publicador<\/a><\/p>\n

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 AND METHODS: 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.<\/p>\n","protected":false},"excerpt":{"rendered":"