title: Influence of autologous blood transfusion on natural killer and lymphokine-activated killer cell activities in cancer surgery.
abstract: OBJECTIVE
  Immunosuppression associated with blood transfusion may influence postoperative infection rates. It may also affect the prognosis of patients treated surgically for colorectal cancer. To control this effect, study protocols have applied autologous blood donation programs, which are thought to be immunologically neutral. However, evidence has emerged that blood donation itself might have suppressive effects on natural killer (NK) cell activities. At present, there are no data available on the effects of autologous blood transfusion on NK or lymphokine-activated killer (LAK) cells. This might be of interest as LAK cells may be active in tumor control.
  
  
  METHODS
  26 patients who underwent surgical resection for colorectal cancer, were assigned at random into two groups: (1) autologous blood donation and transfusion, or (2) allogeneic blood transfusion. NK and LAK activities were determined before blood donation, at surgery, and on the 3rd and 8th postoperative day.
  
  
  RESULTS
  Blood donation induced a small decrease in NK and LAK activities. The postoperative courses of the two groups differed. In the allogeneic group, NK activity (-50%, p = 0.018) and LAK activity decreased (-60.7%, p = 0.043), whereas in the autologous group the decline in LAK was less pronounced (-33.7%, p = 0.091), and their NK activity even increased (+17.4%, p = 0.315). NK activity was modulated differently in the two study groups (0.0036). Differences in LAK activities were found between the 3rd and 8th day postoperatively (p = 0.354).
  
  
  CONCLUSIONS
  In patients receiving autologous blood transfusion, postoperative suppressed NK and LAK activities were modulated. This implies that autologous blood transfusion is not immunologically neutral, but has an intrinsic immunomodulatory potential.
authors.affiliation: Department of Surgery, Klinikum Grosshadern, Ludwig Maximilians University, Munich, Germany.
authors.forename: M M
authors.initials: MM
authors.lastname: Heiss
authors.forename: K
authors.initials: K
authors.lastname: Fasol-Merten
authors.forename: H
authors.initials: H
authors.lastname: Allgayer
authors.forename: M A
authors.initials: MA
authors.lastname: Ströhlein
authors.forename: A
authors.initials: A
authors.lastname: Tarabichi
authors.forename: S
authors.initials: S
authors.lastname: Wallner
authors.forename: H I
authors.initials: HI
authors.lastname: Eissner
authors.forename: K W
authors.initials: KW
authors.lastname: Jauch
authors.forename: F W
authors.initials: FW
authors.lastname: Schildberg
mesh_terms: D000368:Aged; D001804:Blood Transfusion, Autologous; D015179:Colorectal Neoplasms / Q000276:immunology / Q000601:surgery*; D005260:Female; D006801:Humans; D015979:Killer Cells, Lymphokine-Activated / Q000276:immunology*; D007694:Killer Cells, Natural / Q000276:immunology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000276:immunology; D014184:Transplantation, Homologous