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Transfusion of washed and centrifuged shed RBCs during maxillofacial surgery affects cytokine concentrations
R G Rohling1, A P Zimmermann, R Zellweger
1Departments of Cranio-Maxillofacial Surgery, Trauma Surgery, and Internal Medicine (Division of Hematology), Institute of Anesthesiology, University Hospital, Zurich, Switzerland. roman.rohling@ifa.usz.ch
Background:
In patients undergoing elective maxillofacial surgery, hyperthermic reactions have been observed after the transfusion of autologous washed and centrifuged shed blood. It was the aim of this study to correlate the clinical features with changes in cytokine levels.
Study Design And Methods:
In 24 consecutive patients, TNFalpha, IL-1, and IL-6 levels were determined in washed and centrifuged shed RBCs (CS RBCs) and in the patient's serum before, as well as 15 and 120 minutes after transfusion. At the same time, blood was drawn for culture. Patients in whom whole blood was saved through the use of acute normovolemic hemodilution served as a control group (n = 6).
Results:
After the transfusion of CS RBCs, patients had not only elevated cytokine levels but also transient bacteremia involving the pathogens previously detected in CS RBCs. No rise in body temperature occurred.
Conclusion:
In the light of these results, the use of CS RBCs in patients undergoing maxillofacial surgery should be restricted to those patients with no primary bacterial contamination.