Platelet and Leukocyte Activation in Salvaged Blood and the Effect of Its Reinfusion on the Circulating Blood
| Autor: | M. J. Ray, Ross Crawford, Scott Crawford, M. De Jong, Sarah L. Whitehouse |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Total knee Blood Transfusion Autologous Thrombin Internal medicine Leukocytes Humans Medicine Orthopedics and Sports Medicine Platelet Prospective Studies Arthroplasty Replacement Knee Aged Aged 80 and over CD40 biology business.industry Vascular disease Factor V General Medicine Platelet Activation medicine.disease Thrombosis Endocrinology Coagulation Immunology biology.protein Female Surgery business medicine.drug |
| Zdroj: | Clinical Orthopaedics & Related Research. 456:238-242 |
| ISSN: | 0009-921X |
| DOI: | 10.1097/blo.0b013e31802dc4ba |
| Popis: | Postoperative wound drainage reinfusion reduces the frequency of homologous blood transfusion. The salvaged blood is depleted of coagulation factors but may contain platelets and leukocytes which are activated, and therefore potentially procoagulant. We ascertained the degree of activation of platelets and leukocytes in salvaged blood and asked whether their infusion produced any measurable effect on patients' coagulation system. We prospectively randomized 24 patients who had total knee arthroplasties to reinfusion of salvaged autologous blood (n = 12) or a standard drain with no reinfusion (n = 12). Analysis of the salvaged blood showed marked activation of platelets as shown by their expression of P-selectin, CD40 ligand, and Factor V/Va, and as increased numbers of platelet-derived microparticles. After reinfusion there was no measurable effect on activation markers of circulating platelets or leukocytes but there was a decrease in platelet count in the reinfused group compared with the control group. Levels of prothrombin fragment F1 + 2 (suggesting thrombin formation) increased in the reinfused group compared with control group, possibly indicating activation of coagulation systemically. The platelets and leukocytes in salvaged blood are markedly activated and their reinfusion causes a decrease in platelet count in the recipient and a possible increase in thrombin generation potentially favoring thrombosis. |
| Databáze: | OpenAIRE |
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