Determination of eicosanoid and cytokine production in salvaged blood, stored red blood cell concentrates, and whole blood

Study Objective: To determine the production of the eicosanoids prostagland in 2 (PGE2) and thromboxane 2 (TxB2) and the cytokines interleukin 1 beta ( IL-I-beta) and interleukin 6 (IL-6) in whole blood (WB) unfiltered red bloo d cell (RBC), and filtered RBC concentrates, and salvaged blood. Design: Prospective study. Setting: University hospital of Erlangen. Patients: 32 healthy volunteers and 14 ASA physical status I, II and III ra dical prostatectomy patients (mean age 65 yrs). Interventions: Sixteen WB units and 16 RBC units (divided into 16 filtered and unfiltered units each) were taken from 32 volunteers. Fourteen salvaged RBC units were obtained from the 14 radical prostatectomy patients. Sixtee n WB units were stored for 35 days. From the 16 WB donations, RBC concentra tes (PAGGS-M) were prepared. The RBC concentrates were halved one half had its leukocytes removed at day 0; both halves were stored for 49 days. Salva ged blood (n = 14) was stored up to 2 hours during surgery and then retrans fused. Measurements and Main Results: Immediately at the start of the study in all blood: units (WB, RBC filtered, and RBC unfiltered units) at days 0 and 21 , and at the end of the storage period (WB: 35 days, RBC concentrates: 49 d ays) and in the salvaged RBC units, the following parameters were measured: PGE2, TxB2 IL-I-beta, IL-G, hematocrit, platelet number, leukocytes, Blood volume, and hemoglobin. During storage, different levels of PGE2, TxB2, IL -I-beta, IL-6 for WB, filtered RBC concentrates, and unfiltered RBCs were f ound. The higher levels of PGE2, TxB2, IL-I-beta, and IL-6 were found in th e WB and RBC salvaged units than the filtered RBCs or unfiltered RBC units. There was no statistically significant difference between WB and salvaged RBCs. Higher levels of leukocytes and platelets were found in WB units and salvaged RBCs as compared to filtered or unfiltered RBCs. Conclusions: The eicosanoid and cytokine levels in the salvaged filtered RB C, unfiltered RBC, and WB units stayed within physiological limits, suggest ing that these levels do not contribute to the risk of nonhemolytic, immuno modulated transfusion reactions, even in massive transfusions. (C) 2000 by Elsevier Science Inc.