Background and Objective We previously reported that allogeneic red cell (RBC) transfusions (group A) had more serious and prolonged inhibitory effects than acute nor-movolemic hemodilution (ANH) autologous blood transfusions (group B) on immune function of cancer patients undergoing surgery (On the 1st postoperative day, the CD3+T-cell, CD4+ T-cell, CD8+ T-cell and NK cell decreased significantly in both groups but the decrease was more pronounced in group A. On the 5th postoperative day , The CD3+ T-cell, CD4+ T-cell, CD8+ T-cell and NK cell retured to base line in group B but remained low in group A). The inhibitory effects of allogeneic RBC transfusions have been attributed to the white cells (WBC) present in the cellular blood components transfused to patients. This study is to estimate the immunologic changes after WBC-reduced allogeneic RBC transfusions versus ANH autologous transfusions.Methods 30 ASA grade Ⅰ – Ⅱ patients (21 male, 9 female), aged 29-65 years undergoing radical rectal, colon or stomach cancer surgery were randomly divided into two groups: group I (n=15) received ANH autologous transfusions(400-600 ml blood was taken from radial artery of patient while 400-600 ml 6% medium-molecular weight hydroxyethyl starch was infused into patient after tracheal intubation. When bleeding in the course of operation, the 400-600ml autologous blood was transfused to the patient), and group TJ (w=15) received WBC-reduced allogeneic RBC transfusion (WBC in 2 unit allogeneic RBC was filtered by filter bag after cross-match test. When bleeding in the course of operation, the 2 unit WBC-reduced allogeneic RBC was transfused to the patient). The patients preoperative haemoglobin was more than 110g/L and haematocrit value was more than 0. 33. The patients had no endocrine or immune disease and received neither radio-, chemo- nor hormone therapy. The patients were premedicated with intramuscular phenobarbital 0.1g and scoplamine 0. 3mg. Anesthesia was induced with midazolam 0. 15mg · kg-1, fentanyl 3ug · kg-1 and vecuronium 0. 1mg · kg-1. After tracheal intubation the patients were mechanically ventilated. Anesthesia was maintainted with 1 % enflu-rane inhalation, propofol continuous infusion 4mg · kg-1 · h-1 and intermittent intravenn-ous boluses of fentanyl and vecuronium. Venous blood samples were taken at base line (before induction of anesthesia) and on the 0, 1st, 5th postoperative days. CD3+T-cell was analyzed by using CD3-FITC monoclonal antibodies via flow cytometry; CD4+ T-cell was analyzed by using CD4-FITC monoclonal antibodies via flow cytometry; CD8+ T-cell was analyzed by using CD8-PE monoclonal antibodies via flow cytometry; NK cell was analyzed by using CD16+CD56-PE monoclonal antibodies via flow cytometry. The data within group were analyzed by analysis of variance and the data between groups were analyzed by T test.Results The two groups were comparable regard to sex, weighting, type of operation and duration of operation. Before induction of anesthesia; The CDS+ T-cell, CD4+ T-cell, CD8+ T-cell and NK cell in group I were not significantly defferent from those in group II. On the 0 postoperative day: The CD3+T-cell, CD4+ T-cell, CD8+ T-cell and NK cell were not significantly defferent from those at base line in both groups;The CD3+ T-cell, CD4+ T-cell, CD8+ T-cell and NK cell in group I were not significantly defferent from those in group II. On the 1st postoperative day: Compared with those at base line, the CD3+T-cell, CD4+ T-cell, CD8+ T-cell and NK cell decreased significantly (P<0. 05) in both groups; The CD3+ T-cell, CD4+ T-cell, CD8+ T-cell and NK cell in group I were not significantly defferent from those in group II. On the 5th postoperative day: the CD3+T-cell, CD4+ T-cell, CD8+ T-cell and NK cell retured to base line in both groups; The CD3+T-cell, CD4+ T-cell, CD8+ T-cell and NK cell in group I were not significantly defferent from those in group n .Conclusions Like ANH autologous transfusions, WBC-reduced allogeneic RBC transfusions had only minor and passing
↧
