Effect of leukocyte-depleted intraoperative salvaged blood on erythrocyte immunity and systemic inflammatory response during perioperative period

Abstract

Objective To investigate the effect of leukocyte-depleted intraoperative savaged blood on erythrocyte immunity and systemic inflammatory response during perioperative period patients.Methods Sixty patients required blood salvage were randomly divided into two groups by random digits table method with 30 cases each.The patients in control group were given routine autologous blood transfusion,while in observation group,the salvaged blood was filtered with a leukocyte depleting filter placed in the reinfusion circuit.Blood samples were collected from the central vein before anesthesia (T1),at the end of surgery(T2),and at 12 h (T3) and 36 h (T4) after operation in two groups.The rosette rates of RBC-C3b receptors (RBC-C3bRR) and RBC-immune complex (RBC-ICR) were determined.The leukocyte and neutrophil were counted.The plasma levels of interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α) and malondialdehyde (MDA) were measured.Results Compared with control group,the plasma level of IL-6,TNF-α,MDA at T2-T4 in observation group was decreased[T2:(17.8 ± 1.6) ng/L vs.(20.8 ± 1.3) ng/L,(17.4 ± 2.3) ng/L vs.(23.1 ± 2.1) ng/L,(4.31 ± 0.33) nmol/L vs.(4.64 ± 0.73) nmol/L;T3:(21.2 ± 2.0) ng/L vs.(24.3 ± 2.4) ng/L,(12.3 ±2.1) ng/L vs.(18.6 ±1.9) ng/L,(3.97 ±0.35) nmol/L vs.(4.43 ±0.64) nmol/L;T4:(22.0 ± 1.3) ng/L vs.(28.4 ± 1.5) ng/L,(10.6 ± 1.7) ng/L vs.(14.6 ± 2.2) ng/L,(3.45 ± 0.57) nmol/L vs.(3.95 ± 0.40) nmol/L],RBC-C3bRR at T3-T4 in observation group was increased [T3:(15.3 ± 1.3)/100 RBC vs.(12.8 ± 1.5)/100 RBC ;T4:(15.8 ± 1.2)/100 RBC vs.(13.0 ± 1.5)/100 RBC],and there were significant differences (P ＜0.05).There was no significant difference in RBC-ICR,the leukocyte and neutrophil between two groups (P ＞ 0.05).Conclusion Leukocyte-deleted intraoperative salvaged blood is helpful to improve the erythrocyte immunity during perioperative period in patients,and the decrease in the systemic inflammatory response may be involved in the mechanism. Key words: Leukapheresis ; Blood transfusion, autologous ; Immunity; Erythrocytes; Inflammation