Activation of fibrinolysis by reinfusion of unwashed salvaged blood after total knee arthroplasty

In 19 patients with RA and 20 with OA who underwent autotransfusion with unwashed salvaged blood (USB) after total knee arthroplasty, we performed serial measurement of D-dimer, FgDP, t-PA, and PIC in the plasma and salvaged blood. The PIC level at the completion of salvaged blood transfusion was closely correlated with the volume of USB reinfused in the RA group (p < 0.001). The t-PA level of salvaged blood showed a significant positive correlation with the total volume of postoperative drainage in both the RA and OA groups (p < 0.05). The increase of total postoperative drainage associated with reinfusion of USB is largely caused by an increase of t-PA in the salvaged blood.