Impact of intraoperative blood salvage on monocyte subsets alteration and intracellular tumor necrosis factor- production

Intraoperative salvaged blood is used to reduce allogeneic blood transfusion in orthopedic surgery patients. However, salvaged blood reinfusion may lead to immune reactions. Salvaged and venous blood from 20 patients undergoing hip arthroplasty was processed. The salvaged samples were mixed with patients' venous blood and incubated in absence or presence of lipopolysaccharide. Samples: Venous: venous patient blood (n=20). Native: mixed salvaged native blood (n=20). Filtered: mixed salvaged leukocyte filtered blood (n=20). Irradiated: mixed salvaged irradiated blood (n=20). The frequency of the surface receptors CD14, HLA-DR, and intracellular tumor necrosis factor (TNF)- on peripheral blood mononuclear cells was analyzed by fluorescence-activated cell sorting analysis. The frequency of unstimulated CD14(low) and CD14(high) cells as well as unstimulated HLA-DR and TNF- positive monocytes was comparable between venous and filtered salvaged blood. However, native and irradiated salvaged blood increased compared with venous (p<0.05) and filtered salvaged blood (p<0.05) for unstimulated CD14(low) cells, HLA-DR, and TNF- positive monocytes. Stimulated intracellular TNF- positive monocytes were decreased in native, filtered, and irradiated salvaged blood compared with venous blood (p<0.05). Processing perioperative salvaged blood with leukofiltration minimizes the influence on monocytes activation compared with native and irradiated salvaged blood. (c) 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 815-821, 2018.