Effect of allogeneic blood transfusion and preoperative autologous blood donation on perioperative immune function in patients with gastrointestinal tumor
10.12089/jca.2018.02.010
- VernacularTitle:贮存式自体成分输血对胃肠肿瘤患者围术期免疫功能的影响
- Author:
Xun ZHOU
1
;
Huan WANG
;
Xiaoqian LIU
;
Nana ZHU
;
Rong XIA
;
Jianrong GUO
Author Information
1. 第二军医大学附属公利医院麻醉科
- Keywords:
Preoperative autologous blood donation;
Gastrointestinal neoplasms;
Cellular immunity;
Humoral immunity
- From:
The Journal of Clinical Anesthesiology
2018;34(2):144-148
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of allogeneic transfusion and preoperative autologous blood donation on perioperative cellular immunity and humoral immunity in patients with gastrointestinal neoplasms.Methods Sixty gastrointestinal cancer patients undergoing radical surgery,33 males and 27 females,aged 53 69 years,weighing 47-70 kg,ASA physical status Ⅰ or Ⅱ,were included in this study.Blood transfusion was started when the blood loss was more than 200～400 ml,Hb＜70 g/L,and the patients were randomly divided into the preoperative autologous blood donation group (group P,n =30):intraoperative blood transfusion using the stored autologous blood transfusion;allogeneic blood transfusion group (group A,n =30):allogeneic blood transfusion.The levels of T lymphocyte subsets,NK cells and IL-2,IL-10,TNF-α,perforin (PF) concentration and plasma immunoglobulin IgG,IgA and IgM levels.Results The percentage of CD3+,CD4+,NK cells and the ratio of CD4+/CD8+ in group A at the end of surgery to 7 d after operation were significantly lower than those at the time of admission (P＜0.05).The percentage of CD3+,CD4+ (P＜ 0.05).The level of IL-2 in group A was significantly lower than that in group P (P＜0.05) 1-7 d after operation,and the level of IL-10 in group A was significantly higher than that in group P (P＜ 0.05).The levels of IgG and IgA 3 d after operation in group A were significantly lower than those in group P (P＜0.05).The levels of IgG and IgA in group P were significantly decreased at the end of operation and recovered to preoperative levels 1-3 d after operation (P ＜ 0.05).Conclusion Allogeneic blood transfusion can reduce the percentage of T-cell subsets and NK cells in cancer patients and delay their recovery,and also can transiently reduce the content of immunoglobulin IgG and IgA in plasma and thus affect the immune function of patients.However,the preoperative autologous blood donation has a slight effect on postoperative immune function in cancer patients.
