Increased interleukin-6 in collected drainage blood after total knee arthroplasty: an association with febrile reactions during retransfusion

We determined interleukin-6 (IL-6) concentrations in collected shed drainage blood intended for retransfusion in a prospective study in 81 patients after total knee replacement. We found large increases in IL-6 levels, averaging 6.5 (SD 3.9) ng/mL, in shed blood collected in the first 6 postoperative hours. 3 patients had febrile reactions after collected blood was retransfused. The IL-6 levels in the drainage blood of these patients were very high (9.6-13.4 ng/mL). In the blood collected after 6 hours, IL-6 concentrations increased to 47 (SD 33) ng/mL (p < 0.001). These results suggest a relation between increased interleukin-6 concentrations in shed drainage blood and the occurrence of febrile reactions after retransfusion of such blood.