To explore the effect of washing autotransfusion salvage on thromboelastography and immune function of patients undergoing knee and hip arthroplasty surgery.

A total of 186 patients with 400-1 000 ml bleeding and 400-600 ml of recovered blood transfusion during knee and hip arthroplasty surgery who were admitted to the Orthopedics Department of Gansu Provincial Hospital of Traditional Chinese Medicine from January to December 2019 were selected as the observation group, and at the same time 162 patients with allogeneic transfusion were selected as the control group. The postoperative hemoglobin (Hb), red blood cell count (RBC), hematocrit (HCT), thromboelastography, including reaction time (R), maximum amplitude (MA), blood clot formation time (K), α and cellular immune function (including CD3⁺ CD4⁺ T cells, CD3⁺ CD8⁺ T cells, CD16⁺ CD56⁺ NK cells) levels of the two groups of patients before and 1 d, 5 d after blood transfusion were tested and compared.

One day after blood transfusion, Hb (112.57±14.32)g/L, HCT (34.10±3.32)%, RBC (3.12±0.53)×10¹²/L, PLT (125±31)×10⁹/L of the observation group were compared with those of the control group [Hb (108.35±12.84)g/L, HCT (33.52±3.04)%, RBC (2.91±0.42)×10¹²/L, PLT (123±40)×10⁹/L], the differences were not statistically significant (t=0.36, 1.21, 1.37, 1.94, all P>0.05). Five days after blood transfusion, Hb, HCT, RBC, PLT [(122.52±13.70)g/L, (40.12±3.80)%, (3.91±0.45)×10¹²/L, (135±39)×10⁹/L] levels of the observation group were compared with those of the control group [Hb (118.31±13.91)g/L, HCT (35.50±3.70)%, RBC (3.14±0.61)×10¹²/L, PLT (127±31)×10⁹/L], the differences were statistically significant (t=7.01, 5.58, 5.72, 7.61, all P<0.05). One day after blood transfusion, the R, MA, K, α [(5.97±0.31)min, (56.73±2.24)mm, (2.57±0.10)mm, (59.88±1.73)°] of the observation group were compared with those in the control group [R (6.07±0.30)min, MA (57.68±1.78)mm, K (2.70±0.52)min, α (61.12±3.09)°], showing no statistically significant differences (t=2.02, 0.90, 0.66, 0.99, all P>0.05). Five days after blood transfusion, the R, MA, K, α [(6.62±0.59)min, (63.81±0.86)mm, (2.95±0.19)min, (61.12±2.36)°] of the observation group were compared with those of the control group [R (6.82±1.21)min, MA (62.99±1.88)min, K (2.82±0.18)min, α (60.50±2.07)°], showing no statistically significant differences (t=1.70, 1.04, 1.33, 0.56, all P>0.05). Flow cytometry analysis showed that 1 day after blood transfusion, the level of CD3⁺ CD4⁺ T cells in the observation group (33.66±2.10) was significantly higher than that in the control group (29.88±1.97) , the difference was statistically significant (t=3.72, P<0.01). Five days after blood transfusion, the levels of CD3⁺ CD4⁺ T cells (35.92±0.79), CD3⁺ CD8⁺ T cells (21.82±1.61), and CD16⁺ CD56⁺ NK cells (1.68±0.14) of the observation group were significantly higher than those of the control group (29.83±2.11, 20.53±2.71, 1.03±0.13), the differences were statistically significant (t=7.66, 6.57, 9.58, all P<0.01).

Compared with allogeneic transfusion, washing autotransfusion salvage does not affect the R, MA, K, α of thromboelastography of patients undergoing knee and hip arthroplasty surgery, and could improve the patient′s cellular immune function.