Plasma Levels of Eicosanoids after Transfusion of Intraoperatively Salvaged Blood

Abstract

Background: The interest in autologous red blood cell salvage is increasing rapidly, but it is well known that platelets and white cells are activated during cell washing. Therefore, we aimed to determine whether or not eicosanoids transfused together with the salvaged blood are responsible for nonhemolytic immunological transfusion reactions. Materials and Methods: In 11 patients who underwent radical prostatectomy we studied the release of eicosanoids, prostaglandin E2 (PGE2) and thromboxane B2 (TxB2), in association with reinfusion of intraoperatively salvaged blood. Blood samples were taken before operation, on days 1 and 3 after operation and before and after cell washing. Results: There was a twofold increase in PGE2 and a twentyfold increase in TxB2 in the unwashed salvaged blood. Washing caused a reduction in eicosanoid plasma levels of up to 95%, but a significantly lower level in relation to its corresponding preoperative value was only found for PGE2. After transfusion of an average of 420 ml RBC sediment from washed blood, the patients' plasma concentrations of PGE2 and TxB2 on the 1st and 3rd postoperative day did not significantly differ compared to baseline values. Conclusion: Our data support the notion that RBC sediment from ‘salvaged’ and washed autologous blood contains increased amounts of PGE2 and TxB2. It remains, however, questionable if these passively infused eicosanoids become biologically active. According to our study, the PGE2 and TxB2 transfused are apparently not responsible for nonhemolytic immunological transfusion reactions.