Release of interleukin-10 by reinfusion of salvaged blood after knee arthroplasty

Objectives: To determine whether the method of the autotransfusion in assoc iation with knee arthroplasty leads to differences in anti-inflammatory cyt okines in the patient's circulation. Design and setting: Prospective study in a university hospital. Patients: Twenty-one patients undergoing knee arthroplasty were randomized into two groups assigned to postoperative blood salvage. Seven patients rec eived postoperatively filtered salvaged blood, and seven received centrifug ed and washed salvaged blood. Patients with postoperative blood loss less t han 400 ml (n = 7) did not receive any transfusion. Measurements and results: Plasma levels of interleukin (IL) 1 beta, IL-4, a nd IL-10 and of polymorphonuclear leukocyte elastase were measured by enzym e-linked immunosorbent assay. The plasma concentration of IL-10 was elevate d after reinfusion of salvaged blood in all groups I day after surgery (p < 0.05). Plasma IL-6 IL-10, and PMN elastase was higher (p < 0.01) in all gr oups 1 day after surgery than preoperatively. There were significantly high er plasma levels 1 min after retransfusion of IL-6 (p < 0.01) and IL-10 (p < 0.05) in patients receiving filtered blood than in those receiving centri fuged and washed salvaged blood. Conclusion: Total knee arthroplasty results in the release of interleukin-1 0. Transfusion of filtered salvaged blood leads to higher levels of cytokin es IL-6 and IL-10 than after transfusion of washed and centrifuged salvaged blood.