[The effect of intraoperative autotransfusion on the oxygen affinity of erythrocytes]

Intraoperative autotransfusion provides several advantages over homologous transfusion for the recipient. Since the harvested red cells have a normal 2,3-DPG concentration [15, 18], the decreased oxygen affinity of hemoglobin [26] that occurs in the recipient after the transfusion of stored blood is thought to be avoidable by intraoperative autotransfusion. In a study on the influence of harvested cells on oxygen affinity in patients by Orr and Blenko [18], however, it was not possible to demonstrate the superiority of these erythrocytes over stored red cells in the recipient: whereas 2,3-DPG remained at the preoperative level in both groups after transfusion, oxygen affinity increased postoperatively in the study group but not in the control group. In this study we directly determined oxygen affinity in addition to 2,3-DPG in the harvested cells after processing. The influence on the recipients' oxygen affinity after transfusion was analyzed and compared to that of a group of patients who received only stored blood.

Three groups of patients were studied: Group 1 received only autotransfusion blood, group 2 autotransfusion and stored blood, and group 3 only stored blood. For harvesting, centrifugation, and washing of the red cells the Haemonetics Cell Saver (CS III) was used. The p50 value - which is generally accepted as a measurement of oxygen affinity - was determined as described by Müller-Plathe and Müller-Plathe [17]. For analysis of these data, blood was drawn from patients pre- and postoperatively and for the majority of cases also one or more days postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)