Blood transfusion and cytokines' changes in total knee replacement

Area of Science:

• Immunology
• Transfusion Medicine
• Orthopedic Surgery

Background:

• Total knee replacement (TKR) is a common orthopedic procedure.
• Blood transfusions are sometimes necessary during or after TKR.
• The impact of different transfusion strategies on patient immune response and outcomes requires evaluation.

Purpose of the Study:

• To compare serum cytokine levels, adverse reactions, and wound infections in TKR patients receiving no transfusion, allogeneic blood transfusion, or postoperative auto-transfusion (PAT).

Main Methods:

• A prospective study of 248 TKR patients divided into three groups: no transfusion (n=85), PAT (n=92), and allogeneic transfusion (n=71).
• Serum levels of IL-1b, IL-6, IL-8, IL-10, and TNF were measured preoperatively and on postoperative days 1, 3, and 5.
• Demographic data, adverse reactions, and complications were documented.

Main Results:

• Patients receiving blood transfusions showed significantly elevated cytokine levels post-TKR.
• Adverse reactions like chills and pyrexia were more frequent in transfusion groups.
• Superficial wound infections were more common following allogeneic blood transfusion.

Conclusions:

• Blood transfusion alters the immunological status in TKR patients, as indicated by cytokine level changes.
• Postoperative auto-transfusion (PAT) is preferable to allogeneic blood transfusion due to lower rates of adverse reactions and superficial wound infections.