Cytokine levels after transfusion of washed wound drainage in total knee arthroplasty: a randomized trial comparing autologous blood and washed wound drainage.

Overview

Forty patients undergoing total knee arthroplasty (TKA) were prospectively randomized to autologous blood transfusion or retransfusion of washed wound drainage. The wound drainage was washed using a dynamic disk separation chamber. Interleukin (IL)-1 beta, IL-6, IL-8, and tumor necrosis factor (TNF) alpha blood levels were measured prior to epidural anesthesia and at 0, 30, 60, and 120 minutes after initiation of the transfusion. Washed wound drainage contained significantly higher amounts of IL-6 (P < .05) and IL-8 (P < .05) than predonated autologous blood. No significant difference was found for IL-1 beta (P = .28) and TNF-alpha (P = .14). The patients' IL-6 and IL-8 blood levels increased in both groups within 2 hours after the transfusion. This increase was correlated to the time interval between surgery and transfusion (P < .05) and was not significantly different between both groups. No correlation was found between the increase in patients' cytokine levels and the amount of washed wound drainage transfused. According to these results, the increase in IL-6 and IL-8 after transfusion is related to the surgical trauma response and not the transfusion protocol.