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

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

Autor Bordin, Jose Orlando Autor UNIFESP Google Scholar
Chiba, A. K. Google Scholar
Carvalho, Karina Inacio Autor UNIFESP Google Scholar
Takata, E. T. Google Scholar
Falcao, R. P. Google Scholar
Garcia, A. B. Google Scholar
Bordin, IAS Google Scholar
Maciel, M. M. Google Scholar
Andreoni, S. Google Scholar
Kerbauy, J. Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Fac Med Ribeirao Preto
Resumo BACKGROUND: the immunomodulatory effects of allogeneic blood transfusions have been attributed to the white cells (WBCs) present in the cellular blood components transfused to patients.STUDY DESIGN and METHODS:The effect of the transfusion of allogeneic red cells (RBCs) or allogeneic prestorage WBC-reduced RBCs (WBC-reduced RBCs) on host immune responsiveness was evaluated by measuring the lymphocyte subsets and the in-vitro cytokine production in response to phytohemagglutinin stimulation of WBCs of orthopedic surgery patients. Forty-seven patients undergoing hip replacement surgery were randomly assigned to receive allogeneic RBCs (n = 17) or WBC-reduced RBCs (n = 14; 99.95% WBC removal). Sixteen patients were not transfused. Patient blood samples taken before surgery and on Days 1 and 4 after surgery were tested for complete blood count, lymphocyte subset analysis, and measurement of cytokine levels.RESULTS: After surgery, the lymphocyte count was significantly decreased in patients transfused with greater than or equal to 3 units of allogeneic RBCs (2.0 +/- 0.5 vs. 1.3 +/- 0.3 x 10(9)/L; p = 0.017), but not in patients transfused with greater than or equal to 3 units of WBC-reduced RBCs (2.0 +/- 0.9 vs. 1.7 +/- 0.8 x 10(9)/L). Compared with preoperative levels, on Day 4 after surgery, patients transfused with greater than or equal to 3 units of allogeneic RBCs also had a decrease in the number of natural killer cells (0.07 +/- 0.05 vs. 0.04 +/- 0.03 x 10(9)/L; p = 0.018). Postoperatively, interleukin-2 was decreased in one patient who received WBC-reduced RBCs compared with that in four patients transfused with allogeneic RBCs (p = 0.32), and eight untransfused patients (p = 0.01). On Day 4, about 70 percent of patients transfused with allogeneic RBCs showed a 20-percent decrease in the interferon gamma level.CONCLUSION: Taken together, these data support the hypothesis that transfusion of greater than or equal to 3 units of allogeneic RBCs is associated with early postoperative lymphopenia in otherwise healthy individuals undergoing surgery. These findings were not observed in those individuals transfused with RBCs that had undergone prestorage WBC reduction.
Idioma Inglês
Data 1999-07-01
Publicado em Transfusion. Bethesda: Amer Assoc Blood Banks, v. 39, n. 7, p. 718-723, 1999.
ISSN 0041-1132 (Sherpa/Romeo, fator de impacto)
Editor Amer Assoc Blood Banks
Extensão 718-723
Fonte http://dx.doi.org/10.1046/j.1537-2995.1999.39070718.x
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000081428100009
URI http://repositorio.unifesp.br/handle/11600/26109

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