Draxler et al Orthopaedic surgery cellular immune response

Published: 23 November 2020| Version 1 | DOI: 10.17632/78r4z8km43.1
Dominik Draxler


Today tranexamic acid (TXA), an anti-fibrinolytic agent is frequently administered to patients undergoing lower limb arthroplasty in the peri-operative phase to reduce blood loss, after it was shown to be effective and safe in cardiac surgery [1]. We have recently demonstrated profound immunomodulatory effects of TXA in cardiac surgery patients [2], hence assume a similar effect also in other types of major surgery, such as hip- and knee replacement. As a result, we aimed to better characterise the cellular immune response in orthopaedic surgery patient receiving TXA. We therefore collected blood samples and isolated peripheral blood mononuclear cells (PBMCs) from 9 patients undergoing hip- or knee replacement surgery before the beginning of the procedure (preOP), at the end of surgery (EOS), as well as on day 1 (POD-1) and day 3 (POD-3) after the procedure. In this data article we present result on the effect of major orthopaedic surgery on the number of various circulating myeloid and lymphoid cell populations, as well the expression strength of markers involved in immune activation and immunosuppression as well as maturation, migration, cell death and responsiveness to signalling. Moreover, we provide results on the effects of surgery on platelets and red blood cells. Hence, these data may form a new basis for future studies aiming to assess cellular immune function in orthopaedic surgery, given that TXA, identified as an immune modulator, is nowadays routinely used in these patients to reduce blood loss.



Monash University


Anesthesia, Immune Response, Fibrinolysis Inhibitor, Lower Limb Orthopedics, Fibrinolysis