Original Article

No changes in infliximab levels in blood stored for preoperative autologous blood donation

Authors

Keita Nishimura¹, Nobuhiro Wakimoto¹, Jun Sasahara¹, Naotsugu Nakamura¹, Chiaki Yanagisawa¹, Jinju Nishino¹, Hidekazu Tomiyama² and Takashi Matsushita¹

1. Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan
2. Blood Transfusion Service, Teikyo University School of Medicine, Tokyo, Japan

Received:

1 June 2007

Accepted:

6 September 2007

Published online:

20 December 2007

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Abstract

Rheumatoid arthritis (RA) patients requiring total joint arthroplasties under administration of infliximab, which may remain in donated blood if preoperative autologous blood donation (PABD) is undertaken for the surgery, may risk infection. We clarified infliximab hemokinetics in blood stored for such patients. A 20-ml blood sample was obtained from each of the ten RA patients receiving infliximab at just after administration and at 2 and 4 weeks following the administration of infliximab, mixed with 2.8 ml citrate-phosphate-dextrose-adenine (CPDA-1) and stored at 4-6°C. Plasma levels of infliximab in the stored blood were measured just after-mixture with CPDA-1, and at 2 and 4 weeks following the start of storage. Serum levels were also measured just before infliximab administration and at each phlebotomy. The plasma infliximab levels in the stored blood remained close to their original serum levels at the time of each corresponding phlebotomy, only somewhat influenced by dilution of CPDA-1, and sustained for 4 weeks following the start of storage, unlike in vivo, where levels decreased. This suggests that in order to prevent side effects, the later after infusion of infliximab the phlebotomy occurs, the better, and that the amount of stored blood transfusion should be consistent with that of blood loss.

Key words

Arthroplasty - Infection - Infliximab - Preoperative autologous blood donation - Rheumatoid arthritis