Blood transfusions impair anastomotic wound healing, reduce luminol-dependent chemiluminescence, and increase interleukin-8.
OBJECTIVE
Several studies have shown that perioperative blood transfusion increases the risk of infectious complications after surgery or trauma, however, the mechanisms behind the susceptibility to infection and impaired wound healing are not clear. This study was designed to investigate the effects of blood transfusion on anastomotic wound healing, luminol-dependent chemiluminescence, and interleukin-8.


METHODS
Male Wistar rats were divided into seven groups: groups C and Tx underwent laparotomy and the other groups underwent gastrectomy and gastroduodenostomy. Groups C and G received saline; groups Tx and GT received whole blood; and groups GPT, GAT, and GRT received plasma, autologous blood, and irradiated, leukocyte-depleted whole blood, respectively. The breaking strength of the anastomosis, and plasma factor XIII, interleukin-8, and luminol-dependent chemiluminescence levels were measured.


RESULTS
The plasma XIII level in group GT was significantly (P < 0.05) lower that in groups G, GPT, GAT, and GRT. The maximum breaking strength was significantly reduced in groups GT, GRT, GPT, and GAT compared to the other groups, and there was no significance between different types of transfusion. Luminol-dependent chemiluminescence levels in groups GT were severely reduced, while the and luminol-dependent chemiluminescence levels in groups GRT, GPT, and GAT were almost the same as the levels in group G. The plasma interleukin-8 levels were higher in the transfused groups, and lower in groups GRT, GPT, and GAT.


CONCLUSIONS
Blood transfusions increased the incidence of anastomotic abscess and impaired anastomotic wound healing. These might be related to the reduced luminol-dependent chemiluminescence and increased interleukin-8. Autologous blood, plasma, and irradiated, leukocyte-depleted packed cells can abrogate these effects.
Okano
T
T
Second Department of Surgery, Gunma University Faculty of Medicine, 3-39-15 Showa-Machi, Maebashi 371-8511, Japan.
Ohwada
S
S
Sato
Y
Y
Sato
N
N
Toyama
Y
Y
Nakasone
Y
Y
Ogawa
T
T
Morishita
Y
Y
D000714:Anastomosis, Surgical; D000818:Animals; D001803:Blood Transfusion; D004385:Duodenostomy; D005743:Gastrectomy; D007202:Indicators and Reagents; D016209:Interleukin-8 / Q000097:blood*; D008163:Luminescent Measurements; D008165:Luminol; D008297:Male; D009504:Neutrophils / Q000502:physiology; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D014945:Wound Healing / Q000502:physiology*
D007202:Indicators and Reagents; D016209:Interleukin-8; D008165:Luminol