Activation of plasma coagulation by retransfusion of unwashed drainage blood after hip joint arthroplasty - A prospective study

Twelve patients undergoing cementless hip joint arthroplasty were retransfu sed with unwashed drainage blood collected postoperatively. Global coagulat ion parameters, coagulation factors (factor V:C, factor VM:C, activated fac tor XII, and factor XIII) and markers of thrombin generation (F1+2 Fibrin s plit products, thrombin-antithrombin complexes), fibrin generation (fibrino gen and fibrin degradation products), and fibrinolysis (D-dimers, thrombin degradation products, plasminogen) were determined. High levels of factor X IIa, thrombin and fibrin generation markers, and markers of fibrinolysis we re present in the shed blood. After retransfusion (mean, 433 mL), increased levels of these markers together with decreased values for factor XIII and plasminogen were indicative of renewed dot formation and fibrinolysis in t he circulation. These changes were highly significant compared with preretr ansfusion values. The unwashed drainage blood contained high levels of proc oagulation material and induced an activation of the plasma coagulation pat hway with renewed clot formation and fibrinolysis in the patients.