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

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dc.contributor.authorBordin, Jose Orlando [UNIFESP]
dc.contributor.authorChiba, A. K.
dc.contributor.authorCarvalho, Karina Inacio [UNIFESP]
dc.contributor.authorTakata, E. T.
dc.contributor.authorFalcao, R. P.
dc.contributor.authorGarcia, A. B.
dc.contributor.authorBordin, IAS
dc.contributor.authorMaciel, M. M.
dc.contributor.authorAndreoni, S.
dc.contributor.authorKerbauy, J.
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionFac Med Ribeirao Preto
dc.date.accessioned2016-01-24T12:30:51Z
dc.date.available2016-01-24T12:30:51Z
dc.date.issued1999-07-01
dc.description.abstractBACKGROUND: 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.en
dc.description.affiliationUniversidade Federal de São Paulo, Escola Paulista Med, Hematol & Transfus Med Serv, BR-04023902 São Paulo, Brazil
dc.description.affiliationFac Med Ribeirao Preto, Hematol Serv, Ribeirao Preto, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Clin Epidemiol Unit, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Escola Paulista Med, Hematol & Transfus Med Serv, BR-04023902 São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Clin Epidemiol Unit, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent718-723
dc.identifierhttp://dx.doi.org/10.1046/j.1537-2995.1999.39070718.x
dc.identifier.citationTransfusion. Bethesda: Amer Assoc Blood Banks, v. 39, n. 7, p. 718-723, 1999.
dc.identifier.doi10.1046/j.1537-2995.1999.39070718.x
dc.identifier.issn0041-1132
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/26109
dc.identifier.wosWOS:000081428100009
dc.language.isoeng
dc.publisherAmer Assoc Blood Banks
dc.relation.ispartofTransfusion
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.titleThe effect of unmodified or prestorage white cell-reduced allogeneic red cell transfusions on the immune responsiveness in orthopedic surgery patientsen
dc.typeinfo:eu-repo/semantics/article
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