title: Allogenic blood transfusion is an independent risk factor for infective complications after less invasive gastrointestinal surgery.
abstract: 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.
authors.affiliation: Second Department of Surgery, Mie University School of Medicine, Edobashi 2-174, Tsu, Japan.
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Ikuta
authors.forename: Chikao
authors.initials: C
authors.lastname: Miki
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Hatada
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Inoue
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Araki
authors.forename: Kouji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tonouchi
authors.forename: Masato
authors.initials: M
authors.lastname: Kusunoki
mesh_terms: 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
chemical_list: D015850:Interleukin-6; D009363:Neoplasm Proteins; D019947:Receptors, Interleukin-6; C030193:immunosuppressive acidic protein