Allogenic blood transfusion is an independent risk factor for infective complications after less invasive gastrointestinal surgery.
BACKGROUND
The present study aimed to clarify the predisposing factors for postoperative infectious complications after less invasive surgery.


METHODS
A total 150 surgical patients were placed in either group H (operative blood loss > or = 500 mL) or group L (<500 mL). The patients' background factors and postoperative inflammatory responses were assessed.


RESULTS
The operating time was an independent risk factor for infectious complication in group H. In contrast, allogenic blood transfusion was the only significant risk factor for infection in group L. In the patients who received blood transfusion, exaggerated postoperative interleukin-6 response was found in group H, whereas an increased consumption of interleukin-6 soluble receptor with resultant induction of immunosuppressive acidic protein (IAP) were found in group L.


CONCLUSIONS
Perioperative blood transfusion may predominantly contribute to increased susceptibility to infection after less invasive surgery through increased affinity of interleukin-6 soluble receptor and enhanced IAP response.
Ikuta
Shin-ichi
S
Second Department of Surgery, Mie University School of Medicine, Edobashi 2-174, Tsu, Japan.
Miki
Chikao
C
Hatada
Tsuyoshi
T
Inoue
Yasuhiro
Y
Araki
Toshimitsu
T
Tanaka
Kouji
K
Tonouchi
Hitoshi
H
Kusunoki
Masato
M
D000368:Aged; D016063:Blood Loss, Surgical; D013505:Digestive System Surgical Procedures; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000601:surgery; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009363:Neoplasm Proteins / Q000097:blood; D011183:Postoperative Complications; D019947:Receptors, Interleukin-6 / Q000097:blood; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology*; D065227:Transfusion Reaction
D015850:Interleukin-6; D009363:Neoplasm Proteins; D019947:Receptors, Interleukin-6; C030193:immunosuppressive acidic protein