Platelet and Leukocyte Activation in Salvaged Blood and the Effect of Its Reinfusion on the Circulating Blood

de Jong, Marieka, Ray, Michael, Crawford, Scott W., Whitehouse, Sarah L., & Crawford, Ross W. (2007) Platelet and Leukocyte Activation in Salvaged Blood and the Effect of Its Reinfusion on the Circulating Blood. Clinical Orthopaedics and Related Research, 456, pp. 238-242.


Postoperative wound drainage reinfusion reduces the frequency of homologous blood transfusion. The salvaged blood is depleted of coagulation factors but may contain platelets and leukocytes which are activated, and therefore potentially procoagulant. We ascertained the degree of activation of platelets and leukocytes in salvaged blood and asked whether their infusion produced any measurable effect on patients’ coagulation system. We prospectively randomized 24 patients who had total knee arthroplasties to reinfusion of salvaged autologous blood (n = 12) or a standard drain with no reinfusion (n = 12). Analysis of the salvaged blood showed marked activation of platelets as shown by their expression of P-selectin, CD40 ligand, and Factor V/Va, and as increased numbers of platelet-derived microparticles. After reinfusion there was no measurable effect on activation markers of circulating platelets or leukocytes but there was a decrease in platelet count in the reinfused group compared with the control group. Levels of prothrombin fragment F 1+2 (suggesting thrombin formation) increased in the reinfused group compared with control group, possibly indicating activation of coagulation systemically. The platelets and leukocytes in salvaged blood are markedly activated and their reinfusion causes a decrease in platelet count in the recipient and a possible increase in thrombin generation potentially favoring thrombosis.

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12 citations in Scopus
11 citations in Web of Science®
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ID Code: 7152
Item Type: Journal Article
Refereed: Yes
Additional Information: Author contact details:
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ISSN: 1528-1132
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Orthopaedics (110314)
Divisions: Past > QUT Faculties & Divisions > Faculty of Built Environment and Engineering
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2007 Lippincott Williams & Wilkins
Copyright Statement: This is the author-version of the work. The final, definitive version of this article has been published in the Journal, < Clinical Orthopaedics and Related Research 456:pp. 238-242, 2007 © < Lippincott, Williams & Wilkins.
Deposited On: 26 Apr 2007 00:00
Last Modified: 29 Feb 2012 13:33

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