Connall T P, Zhang J, Vaziri N D, Kaupke C J, Wilson S E
Department of Surgery, University of California, Irvine Medical Center.
Am Surg. 1994 Oct;60(10):797-800.
To investigate whether activated leukocytes are present in salvaged blood, we measured complete blood counts and quantified the surface expression of the leukocyte adhesion receptors CD11b and CD18 in salvaged blood and arterial blood from six male patients undergoing elective abdominal aortic aneurysm repair. Salvaged blood contained 5,450 +/- 1010 leukocytes/microL and 7600 +/- 6200 platelets/microL and had a hematocrit of 50.6 +/- 3.7%. CD 11b expression was 3.3 +/- 0.5 fold higher on neutrophils and 3.8 +/- 1.0 fold higher on monocytes from salvaged blood compared with arterial blood (P < 0.05 for both). CD18 expression was increased 3.2 +/- 0.2 fold on neutrophils and 2.5 +/- 0.4 fold on lymphocytes (P < 0.05) in salvaged compared to arterial blood (P < .05). Monocyte expression of CD18 was increased 4.50 +/- 1.1 fold in salvaged blood, but this difference was not statistically significant. We conclude that a substantial number of activated leukocytes are present in salvaged blood. Because activated leukocytes could potentially be detrimental to the recipient, our findings raise theoretical concerns about the use of salvaged blood and emphasize the need for further refinement of the procedure.
为了研究回收血中是否存在活化的白细胞，我们对6名接受择期腹主动脉瘤修复术的男性患者的回收血和动脉血进行了全血细胞计数，并对白细胞黏附受体CD11b和CD18的表面表达进行了定量分析。回收血中白细胞含量为5450±1010/μL，血小板含量为7600±6200/μL，血细胞比容为50.6±3.7%。与动脉血相比，回收血中中性粒细胞的CD11b表达高3.3±0.5倍，单核细胞的CD11b表达高3.8±1.0倍（两者P均<0.05）。与动脉血相比，回收血中中性粒细胞的CD18表达增加3.2±0.2倍，淋巴细胞的CD18表达增加2.5±0.4倍（P<0.05）。回收血中单核细胞的CD18表达增加4.50±1.1倍，但差异无统计学意义。我们得出结论，回收血中存在大量活化的白细胞。由于活化的白细胞可能对受者有害，我们的研究结果引发了对使用回收血的理论担忧，并强调需要进一步完善该程序。
