The effect of unmodified or prestorage white cell‐reduced allogeneic red cell transfusions on the immune responsiveness in orthopedic surgery patients

Bordin, José Orlando; Chiba, Akemi Kuroda; Carvalho, Karina I.; Takata, Edmilson Takehiro; Falcao, R P; Garcia, Ana Beatriz Andrêo; Bordin, Isabel Altenfelder Santos; Maciel, M.M.; Andreoni, Solange; Kerbauy, J

doi:10.1046/j.1537-2995.1999.39070718.x

Cited by 36 publications

(41 citation statements)

References 27 publications

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“…Some previous studies observed that the levels of CRP and IL-6 were relative with age,[16] gender,[17] BMI,[18] the total blood loss[1920] or transfusion,[21] or postoperative pain. [12] However, in this study, there were no significant relationships between these background variables and CRP or IL-6 levels.…”

Section: Discussionmentioning

confidence: 99%

Relationship between Inflammatory Response and Estimated Complication Rate after Total Hip Arthroplasty

Chen

Wang

et al. 2016

Chinese Medical Journal

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Background:After total hip arthroplasty (THA), there is a noteworthy inflammatory response. The inflammatory response is associated with postoperative recovery and complications. However, there had been few reports on the relationship between inflammatory response and postoperative complication rate. The aim of the present study was to investigate early inflammatory response in the first 3 days after THA, and to identify the relationship between inflammatory response and estimated complication rate after surgery.Methods:It was a prospective, nonrandomized cohort study. There were 148 patients who underwent unilateral THA in our hospital enrolled. Blood samples were collected preoperatively in the morning of the surgery and at 24, 48, and 72 h after surgery. C-reactive protein (CRP) and interleukin-6 (IL-6) in peripheral blood were measured. The modified physiological and operative severity score for the enumeration of the morbidity (POSSUM) was recorded pre- and intra-operatively. Based on the score, estimated complication rate was calculated. Harris score was used to assess hip function before and after surgery.Results:IL-6 levels reached the peak at 24 h after surgery and CRP at 48 h. After that, both of the levels decreased. The mean Harris scores significantly increased from 41.62 ± 23.47 before surgery to 72.75 ± 9.13 at 3 days after surgery. The Harris scores after surgery did not have a significant relation with either IL-6 or CRP peak levels (P = 0.165, P = 0.341, respectively). Both CRP and IL-6 peak levels significantly and positively correlated with estimated complication rate after surgery. The estimated complication rate calculated using the POSSUM system was 43 cases of 148 patients. Actually, there were only 28 cases that were observed to get postoperative complications during hospitalization. However, there was no significant difference between estimated and observed complication rates (P = 0.078). In the group with complications, the CRP and IL-6 peak levels were significantly higher than those in the group without complications (both P < 0.001).Conclusions:There were significantly positive relationships between both peak levels of CRP and IL-6 and estimated complication rate after THA. Inflammatory response could predict the incidence of complications after THA.

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Section: Discussionmentioning

confidence: 99%

Relationship between Inflammatory Response and Estimated Complication Rate after Total Hip Arthroplasty

Chen

Wang

et al. 2016

Chinese Medical Journal

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“…Despite the fact that the mechanisms involved in the immunomodulatory effect of allogeneic blood transfusion have not been thoroughly elucidated yet, it has been suggested that the majority of these effects is mediated by the interaction of white blood cells (or their products) in transfused blood and anti-leukocyte antibodies in the recipient plasma [54–56]. It has also been shown that patients transfused with blood without prestorage leukocyte reduction might present lymphocyte count alterations associated with a decrease in natural killer T-cells and therefore be at higher risk for postoperative bacterial infection episodes [57]. Therefore, TRIM seems to depend on the degree of contamination of transfused blood with leukocytes, storage time, and cytokine content [12, 38].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Two Different Transfusion Strategies on Patient Immune Response during Major Abdominal Surgery: A Preliminary Report

Theodoraki

Markatou

Rizos

et al. 2014

Journal of Immunology Research

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Blood transfusion is associated with well-known risks. We investigated the difference between a restrictive versus a liberal transfusion strategy on the immune response, as expressed by the production of inflammatory mediators, in patients subjected to major abdominal surgery procedures. Fifty-eight patients undergoing major abdominal surgery were randomized preoperatively to either a restrictive transfusion protocol or a liberal transfusion protocol (with transfusion if hemoglobin dropped below 7.7 g dL−1 or 9.9 g dL−1, respectively). In a subgroup of 20 patients randomly selected from the original allocation groups, blood was sampled for measurement of IL-6, IL-10, and TNFα. Postoperative levels of IL-10 were higher in the liberal transfusion group on the first postoperative day (49.82 ± 29.07 vs. 15.83 ± 13.22 pg mL−1, P < 0.05). Peak postoperative IL-10 levels correlated with the units of blood transfused as well as the mean duration of storage and the storage time of the oldest unit transfused (r 2 = 0.38, P = 0.032, r 2 = 0.52, P = 0.007, and r 2 = 0.68, P<0.001, respectively). IL-10 levels were elevated in patients with a more liberal red blood cell transfusion strategy. The strength of the association between anti-inflammatory IL-10 and transfusion variables indicates that IL-10 may be an important factor in transfusion-associated immunomodulation. This trial is registered under ClinicalTrials.gov Identifier: NCT02020525.

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“…ABT induced a higher impairment of postoperarive immunity (decreased CD4/CD8 ratio) than a proinflammatory response (high serum levels of IL-6 and IL-10) (Ydy et al, 2007). The immuno -suppressant effect has been related to the blood transfusion volume (Bordin et al, 1999 ;Ikuta et al, 2003 ;Ydy et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Effects of Allogeneic Blood Transfusion in Patients with Stage II Colon Cancer

Lu²,

Tang³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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The aim of the present study was to determine whether allogeneic red blood cell transfusions showed a deleterious effect and what might be preoperative risk factors for blood transfusion in patients with TNM stage II colon cancer. Total 470 patients who fulfilled inclusion criteria were selected for a further 10-year followup study. We found that there were statistical significance between non-transfused and transfused group in mortality (P=0.018), local recurrence (P=0.000) and distant metastasis (P=0.040). Local recurrence and distant metastasis between 1 to 3 units and more than 3 units group did not show any significant differences. There was no difference in survival rate between non-transfused and 1 to 3 units group (log rank =0.031, P=0.860). The difference between different blood transfusion volume in transfused patients was found (78.77% vs 63.83%, P=0.006). Meanwhile, the significant difference of survival rate was existed between non-transfused group and more than 3 units group (84.83% vs 63.83%, P=0.002 ). Univariate analysis showed the following 3 variables to be associated with an increased risk of allogeneic blood transfusions: preoperative CEA level (P<0.05), location of tumor (P<0.01) and diameter of tumor (P<0.01). Multivariate analysis revealed that location of tumor and diameter of tumor are two independent factors for requirement of perioperative transfusions. Therefore, allogeneic transfusion increase the postoperative tumor mortality, local recurrence and distant metastasis in patients with stage II colon cancer. The postoperative tumor mortality, local recurrence and distant metastasis were not associated with the blood transfusion volume. The blood transfusion volume was associated with the survival rate. Location of tumor and diameter of tumor were the independent preoperative risk factors for blood transfusion.

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The effect of unmodified or prestorage white cell‐reduced allogeneic red cell transfusions on the immune responsiveness in orthopedic surgery patients

Cited by 36 publications

References 27 publications

Relationship between Inflammatory Response and Estimated Complication Rate after Total Hip Arthroplasty

Relationship between Inflammatory Response and Estimated Complication Rate after Total Hip Arthroplasty

The Impact of Two Different Transfusion Strategies on Patient Immune Response during Major Abdominal Surgery: A Preliminary Report

Effects of Allogeneic Blood Transfusion in Patients with Stage II Colon Cancer

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