Postoperative Inflammatory Response after Autologous and Allogeneic Blood Transfusion

1997 ◽  
Vol 87 (3) ◽  
pp. 511-516 ◽  
Author(s):  
Anders Avall ◽  
Monica Hyllner ◽  
Jan Peter Bengtson ◽  
Lars Carlsson ◽  
Anders Bengtsson
Keyword(s):  
Blood Transfusion ◽  
Autologous Blood ◽  
Plasma Concentrations ◽  
Allogeneic Blood Transfusion ◽  
Allogeneic Blood ◽  
Autologous Blood Transfusion ◽  
Blood Transfusions ◽  
Joint Replacement Surgery ◽  
Autologous Whole Blood ◽  
Significant Difference

Background Allogeneic blood transfusions cause immunosuppression. The aim of this study was to determine whether complement anaphylatoxins, cytokines, or both are released in the recipient, after blood transfusions in general, and after autologous blood transfusions in particular. Methods Thirty-one patients having total hip joint replacement surgery were randomized to receive either allogeneic red blood cells (n = 15) or predeposited autologous whole blood transfusion (n = 16). Plasma concentrations of the anaphylatoxins C3a and C5a, the terminal C5b-9 complement complex, and cytokines IL-6 and IL-8 in the recipients were repeatedly analyzed before, during, and after surgery. Results Significantly increased concentrations of IL-6 and IL-8 appeared in both groups, with a significantly greater increase in the autologous blood group. Patients in both groups developed a moderate but significant increase of C3a without a significant difference between them. C5a and terminal C5b-9 complement complex were not greatly changed. Conclusions The study showed a greater increase in cytokine concentration after autologous blood transfusion than after allogeneic blood transfusion. The lower response in the latter may result from transfusion-induced suppression of cellular immunity.

Do autologous blood transfusion systems reduce allogeneic blood transfusion in total knee arthroplasty?

2016 ◽  
Vol 25 (9) ◽  
pp. 2957-2966 ◽  
Author(s):  
Aditya Pawaskar ◽  
Abhijeet Ashok Salunke ◽  
Aashay Kekatpure ◽  
Yongsheng Chen ◽  
G. I. Nambi ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Transfusion ◽  
Knee Arthroplasty ◽  
Autologous Blood ◽  
Allogeneic Blood Transfusion ◽  
Allogeneic Blood ◽  
Autologous Blood Transfusion ◽  
Total Knee

scholarly journals Transfusion of autologous blood

Medicina ◽  
2008 ◽  
Vol 44 (6) ◽  
pp. 482
Author(s):  
Audronė Veikutienė ◽  
Edmundas Širvinskas ◽  
Dalia Adukauskienė
Keyword(s):  
Blood Transfusion ◽  
Blood Donation ◽  
Autologous Blood ◽  
Allogeneic Blood Transfusion ◽  
Allogeneic Blood ◽  
Autologous Blood Transfusion ◽  
Donor Blood ◽  
Autologous Transfusion ◽  
Preoperative Autologous Blood Donation ◽  
Blood Salvage

Recently the use of allogeneic (donor) blood transfusion is widely accepted in the clinical practice. Despite of good quality and safety of preparation of allogeneic blood, there are some risks related with transfusion: hemolytic, febrile, and allergic reactions, transfusion related acute lung injury, negative immunomodulatory effect, transmission of infections diseases, dissemination and recurrence of cancer. This is why the indications for donor blood transfusion are restricted, so new safer methods are discovered to avoid or to decrease the heed for allogeneic blood transfusion. Nowadays, there is an increased interest in autologous blood transfusion as the most acceptable alternative to allogeneic blood transfusion. Autologous transfusion is the collection and reinfusion of the patient’s own blood (donor and recipient is the same person). Several types of autologous transfusion can be used: preoperative autologous blood donation, acute normovolemic hemodilution, intraoperative blood salvage, postoperative blood salvage. Neverless, autologous transfusion does not protect from all risks, it still remains the safest type of blood transfusion and is important in the strategy of blood conservation.

Blood transfusion-modulated tumor recurrence: first results of a randomized study of autologous versus allogeneic blood transfusion in colorectal cancer surgery.

1994 ◽  
Vol 12 (9) ◽  
pp. 1859-1867 ◽  
Author(s):  
M M Heiss ◽  
W Mempel ◽  
C Delanoff ◽  
K W Jauch ◽  
C Gabka ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Relative Risk ◽  
Blood Transfusion ◽  
Blood Group ◽  
Tumor Recurrence ◽  
Autologous Blood ◽  
Randomized Study ◽  
Allogeneic Blood Transfusion ◽  
Allogeneic Blood ◽  
Blood Transfusions

PURPOSE Allogeneic blood transfusions have reportedly been associated with a poor prognosis in patients with curatively resected cancer. To control for immunosuppression induced by a speculatively causal allogeneic blood transfusion, we designed a randomized study in which the control group received autologous blood transfusions not related to any condition of immunosuppression. PATIENTS AND METHODS One hundred twenty patients with potentially curative resectable colorectal cancer and the capability to predeposit autologous blood were randomly selected to receive either standard allogeneic blood transfusion or predeposited autologous blood. RESULTS In curatively resected cancer patients, the number who needed allogeneic blood transfusions was reduced from 60% in the allogeneic blood group to 33% in the autologous blood group (P = .009). After a median follow-up duration of 22 months (range, 8 to 48) tumor recurrence was observed in 28.9% of the allogeneic blood group and 16.7% of the autologous blood group. Life-table analysis established a tendency toward a shorter tumor-free survival for the allogeneic blood group (log-rank P = .11). The problem with this analysis was the strong association of allogeneic blood transfusions with tumor recurrence, which interfered in 33% of patients in the autologous blood group who required additional allogeneic blood transfusions. Multivariate analysis of established risk factors for tumor recurrence and surgery-related variables reflecting potential immunosuppressive conditions showed that only pT stage (relative risk, 6.61; 95% confidence interval [CI], 1.82 to 23.99; P = .004), pN stage (relative risk, 8.39; 95% CI, 3.15 to 22.33; P < .001), and the need for allogeneic blood (relative risk, 6.18; 95% CI, 2.20 to 17.37; P < .001) were independent predictors of tumor recurrence. Subgroup analysis of patients who received a transfusion of < or = 2 U blood found a significantly higher risk of tumor recurrence in the allogeneic blood group (relative risk, 5.16; 95% CI, 1.13 to 23.62; P = .034), which was reduced to borderline significance (relative risk, 3.54; 95% CI, 0.76 to 16.51; P = .107) by adjustment for tumor (T) and node (N) stage. CONCLUSION As indicated by these first results, the blood transfusion modality has a significant effect on tumor recurrence after surgical treatment of colorectal cancer. A change in the practice of blood transfusion might thus potentially surpass the impact of any recent adjuvant treatment strategies.

scholarly journals Autologous blood transfusion in total knee replacement surgery

2013 ◽  
Vol 70 (3) ◽  
pp. 274-278 ◽  
Author(s):  
Mirka Lukic-Sarkanovic ◽  
Ljiljana Gvozdenovic ◽  
Dragan Savic ◽  
Miroslav Ilic ◽  
Gordana Jovanovic
Keyword(s):  
Blood Transfusion ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Autologous Blood ◽  
Allogeneic Blood ◽  
Autologous Blood Transfusion ◽  
Knee Replacement Surgery ◽  
Replacement Surgery ◽  
Total Knee Replacement Surgery ◽  
Total Knee

Background/Aim. Total knee replacement (TKR) surgery is one of the most frequent and the most extensive procedures in orthopedic surgery, accompanied with some serious complications. Perioperative blood loss is one of the most serious losses, so it is vital to recognize and treat such losses properly. Autologous blood transfusion is the only true alternative for the allogeneic blood. The aim of this study was to to examine if autologous blood transfusion reduces usage of allogenic blood in total knee replacement surgery, as well as to examine possible effect of autologous blood transfusion on postoperative complications, recovery and hospital stay of patients after total knee replacement surgery. Methods. During the controlled, prospective, randomised study we compared two groups of patients (n = 112) with total prosthesis implanted in their knee. The group I consisted of the patients who received the transfusion of other people?s (allogeneic) blood (n = 57) and the group II of the patients whose blood was collected postoperatively and then given them [their own (autologous) blood] (n = 55). The transfusion trigger for both groups was hemoglobin level of 85 g/L. Results. In the group of patients whose blood was collected perioperatively only 9 (0.9%) of the patients received transfusion of allogeneic blood, as opposed to the control group in which 98.24% of the patients received the transfusion of allogeneic blood (p ? 0.01). The patients whose blood was collected stayed in hospital for 6.18 days, while the patients of the control group stayed 7.67 days (p < 0.01). Conclusion. Autologous blood transfusion is a very effective method for reducing consumption of allogenic blood and thus, indirectly for reducing all complications related to allogenic blood transfusion. There is also a positive influence on postoperative recovery after total knee replacement surgery due to the reduction of hospital stay, and indirectly on the reduction of hospital costs.

scholarly journals The Role of Autologous Blood Transfusion in Joint Replacement Surgery

1995 ◽  
Vol 23 (4) ◽  
pp. 472-477 ◽  
Author(s):  
E. T. Mah ◽  
R. Davis ◽  
P. Seshadri ◽  
T. L. M. Nyman ◽  
R. Seshadri
Keyword(s):  
Blood Transfusion ◽  
Joint Replacement ◽  
Autologous Blood ◽  
Cost Comparison ◽  
Autologous Blood Transfusion ◽  
Homologous Blood Transfusion ◽  
Blood Salvage ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Cost Comparison Analysis

The efficacy of predeposited autologous blood transfusion (PABT) with and without intra/postoperative blood salvage to reduce or eliminate the need for homologous blood transfusion (HBT) in primary total hip or knee replacement surgery was investigated by retrospective and prospective studies. Depending on the type of surgery, one to three units of PABT eliminated the need for HBT in 50 to 78% of patients, but, intra/postoperative blood salvage alone reduced the need only in 11 to 29%. In contrast, blood salvage, when combined with three units of PABT, eliminated the need for HBT in all patients undergoing primary joint replacement surgery. A cost comparison analysis showed that blood salvage was more expensive than PABT, and therefore it should be limited to patients who had predeposited fewer than three units of autologous blood.

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