title: Inflammatory response, immunosuppression, and cancer recurrence after perioperative blood transfusions.
abstract: Debate on appropriate triggers for transfusion of allogeneic blood products and their effects on short- and long-term survival in surgical and critically ill patients continue with no definitive evidence or decisive resolution. Although transfusion-related immune modulation (TRIM) is well established, its influence on immune competence in the recipient and its effects on cancer recurrence after a curative resection remains controversial. An association between perioperative transfusion of allogeneic blood products and risk for recurrence has been shown in colorectal cancer in randomized trials; whether the same is true for other types of cancer remains to be determined. This article focuses on the laboratory, animal, and clinical evidence to date on the mechanistic understanding of inflammatory and immune-modulatory effects of blood products and their significance for recurrence in the cancer surgical patient.
authors.affiliation: Department of Anaesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Centre, 1515 Holcombe Blvd, Unit 409, Houston, TX 77030, USA. jcata@mdanderson.org
authors.forename: J P
authors.initials: JP
authors.lastname: Cata
authors.forename: H
authors.initials: H
authors.lastname: Wang
authors.forename: V
authors.initials: V
authors.lastname: Gottumukkala
authors.forename: J
authors.initials: J
authors.lastname: Reuben
authors.forename: D I
authors.initials: DI
authors.lastname: Sessler
mesh_terms: D015179:Colorectal Neoplasms / Q000601:surgery; D006801:Humans; D007108:Immune Tolerance; D009369:Neoplasms / Q000209:etiology* / Q000276:immunology; D019990:Perioperative Care / Q000009:adverse effects / Q000379:methods; D012008:Recurrence; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology*; D065227:Transfusion Reaction