Effect of perioperative allogeneic red blood cell transfusion on the immune-inflammatory response after colorectal cancer resection.
Cytokines play an important role in the acute-phase response to trauma. Few studies have analyzed the effects of allogeneic blood transfusion containing packed red blood cells (RBCs) on the early postoperative immune/inflammatory response after colorectal resection for cancer This study investigated whether allogeneic RBC transfusion influences the postoperative immune/inflammatory response of patients submitted to large bowel resection due to cancer. A total of 26 patients -- 15 men and 11 women, with a median age of 56.5 years (range 24-87 years) -- were prospectively studied. Blood samples were obtained preoperatively and on the first and fourth postoperative days for C-reactive protein (CRP), interleukin-6 (IL-6), and IL-10 assays and for CD4 and CD8 lymphocyte counts. Transfused (> or =3 and <3 units), and nontransfused patients were compared. Both IL-6 and IL-10 increased postoperatively in transfused patients (p < 0.01). The serum IL-6 level was higher in patients receiving > or =3 units of RBCs (p < 0.01). CRP increased postoperatively unrelated to blood transfusion. The CD8 count decreased (p < 0.04) in transfused subjects, whereas CD4 decreased (p < 0.01) only in major-transfusion patients. Perioperative allogeneic RBC transfusion enhances the inflammatory systemic response and decreased immunity in patients submitted to colorectal resection for cancer.
Department of Surgery, Federal University of Mato Grosso, Cuiaba, Brazil.
Lenuce Ribeiro Aziz
LR
Ydy
Natasha
N
Slhessarenko
José Eduardo
JE
de Aguilar-Nascimento
D000230:Adenocarcinoma / Q000276:immunology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis; D018791:CD4 Lymphocyte Count; D018414:CD8-Positive T-Lymphocytes; D015179:Colorectal Neoplasms / Q000276:immunology / Q000601:surgery*; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D016753:Interleukin-10; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D014184:Transplantation, Homologous
D015850:Interleukin-6; D016753:Interleukin-10; D002097:C-Reactive Protein