Fujisan classification predicts fibrinogen concentration after allogeneic blood transfusion but not after hemodilutional autologous blood transfusion in cardiac surgery with cardiopulmonary bypass

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.

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Transfusion of autologous blood

Medicina ◽

10.3390/medicina44060063 ◽

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.

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Autologous Blood Transfusion: Evaluation of an Alternative Strategy in Reducing Exposure to Allogeneic Blood Transfusion

Immunological Investigations ◽

10.3109/08820139509062792 ◽

1995 ◽

Vol 24 (1-2) ◽

pp. 435-441 ◽

Cited By ~ 3

Author(s):

S. Qutaishat

Keyword(s):

Blood Transfusion ◽

Autologous Blood ◽

Allogeneic Blood Transfusion ◽

Alternative Strategy ◽

Allogeneic Blood ◽

Autologous Blood Transfusion

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Cost analysis of autologous blood transfusion, using cell salvage, compared with allogeneic blood transfusion

Transfusion Medicine ◽

10.1046/j.1365-3148.1997.d01-25.x ◽

1997 ◽

Vol 7 (3) ◽

pp. 189-196 ◽

Cited By ~ 18

Author(s):

G. Duffy ◽

K. Tolley

Keyword(s):

Blood Transfusion ◽

Cost Analysis ◽

Autologous Blood ◽

Allogeneic Blood Transfusion ◽

Allogeneic Blood ◽

Autologous Blood Transfusion ◽

Cell Salvage

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Autotransfusion in cardiac surgery

Perfusion ◽

10.1177/026765910101600509 ◽

2001 ◽

Vol 16 (5) ◽

pp. 391-400 ◽

Cited By ~ 14

Author(s):

M H Cross

Keyword(s):

Cardiac Surgery ◽

Blood Transfusion ◽

Autologous Blood ◽

Perioperative Period ◽

Outcome Data ◽

Allogeneic Blood Transfusion ◽

Allogeneic Blood ◽

Cell Salvage ◽

Mortality And Morbidity ◽

Acute Normovolaemic Haemodilution

There are a number of problems with allogeneic blood transfusion. Some of these problems are defined and can be quantified, such as the problem of rising cost or the risk of viral infection, but some of the problems are not well defined and it is only outcome data that point to allogeneic blood transfusion contributing to patient mortality and morbidity. Autotransfusion includes any technique in which the patient’s own blood is collected, processed and stored, followed by reinfusion when circumstances dictate. In the perioperative period of cardiac surgery, a number of techniques are recognized as useful in this context. Preoperative autologous donation, with or without erythropoietin supplementation, intraoperative acute normovolaemic haemodilution, intraoperative cell salvage, postoperative cell salvage (reinfusion of shed mediastinal blood) and platelet rich plasmapheresis are all techniques which are used with more or less enthusiasm to reduce the need for an allogeneic blood transfusion. Modification of the priming technique of the cardiopulmonary bypass circuit using an autologous blood prime is included in this review even though it does not fall strictly within the definition of autotransfusion. Although autotransfusion is not the answer to every problem, there is no doubt that it should play a significant part in the strategy of blood conservation.

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