Postoperative inflammatory response after autologous and allogeneic blood transfusion.
BACKGROUND
Allogeneic blood transfusions cause immunosuppression. The aim of this study was to determine whether complement anaphylatoxins, cytokines, or both are released in the recipient, after blood transfusions in general, and after autologous blood transfusions in particular.


METHODS
Thirty-one patients having total hip joint replacement surgery were randomized to receive either allogeneic red blood cells (n = 15) or predeposited autologous whole blood transfusion (n = 16). Plasma concentrations of the anaphylatoxins C3a and C5a, the terminal C5b-9 complement complex, and cytokines IL-6 and IL-8 in the recipients were repeatedly analyzed before, during, and after surgery.


RESULTS
Significantly increased concentrations of IL-6 and IL-8 appeared in both groups, with a significantly greater increase in the autologous blood group. Patients in both groups developed a moderate but significant increase of C3a without a significant difference between them. C5a and terminal C5b-9 complement complex were not greatly changed.


CONCLUSIONS
The study showed a greater increase in cytokine concentration after autologous blood transfusion than after allogeneic blood transfusion. The lower response in the latter may result from transfusion-induced suppression of cellular immunity.
Avall
A
A
Department of Anesthesiology and Intensive Care, Sahlgrenska University Hospital, Göteborg, Sweden.
Hyllner
M
M
Bengtson
J P
JP
Carlsson
L
L
Bengtsson
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001804:Blood Transfusion, Autologous; D015926:Complement C3a / Q000032:analysis; D005260:Female; D006801:Humans; D007108:Immune Tolerance; D007249:Inflammation / Q000209:etiology*; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D065227:Transfusion Reaction
D015850:Interleukin-6; D016209:Interleukin-8; D015926:Complement C3a