Protective effect of blood transfusions on postoperative recurrence of Crohn's disease in parous women.
BACKGROUND
Perioperative blood transfusion (BT) appeared to have adverse effects on survival after surgery for malignant tumors while pretransplantation BT suppressed allograft rejection. Interest grew in the effect of BT on postoperative recurrence of Crohn's disease.


METHODS
To determine the effect of perioperative BT on the recurrence of Crohn's disease after primary surgery, the medical histories of 148 patients with Crohn's disease, 62 males and 86 females (49 nonparous and 37 parous), were reviewed. Eighty-seven patients received perioperative BT.


RESULTS
Overall, perioperative BT showed no effect on recurrence. Patients with Crohn's disease limited to the ileum had a better prognosis with regard to recurrence than did patients with Crohn's disease located in the colon or located in both ileum and colon, but the difference was not significant. Perioperative transfusion seemed to protect against recurrent disease after colon resection, which might be explained by the fact that colon resections, which often necessitate perioperative BT, generally result in a shorter bowel segment at risk for recurrent disease. Overall, parous women showed a worse prognosis than nonparous females and men (p = 0.022). Transfusions had a beneficial effect in parous women (p = 0.068) and, after correction for type of operation, this beneficial effect was significant (p = 0.026). After perioperative BT, parous women had a similar prognosis with respect to recurrent Crohn's disease as nonparous females and men.


CONCLUSIONS
Perioperative BT has a beneficial effect on the postoperative recurrence of Crohn's disease in parous women.
Silvis
R
R
Department of Surgery, University Hospital Leiden, The Netherlands.
Steup
W H
WH
Brand
A
A
Zwinderman
K A
KA
Lamers
C B
CB
Griffioen
G
G
Gooszen
H G
HG
D000293:Adolescent; D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D002648:Child; D003092:Colitis / Q000601:surgery; D003424:Crohn Disease / Q000601:surgery* / Q000628:therapy; D005260:Female; D006801:Humans; D007079:Ileitis / Q000601:surgery; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D010298:Parity; D011379:Prognosis; D012008:Recurrence