Effect of Perioperative Allogeneic Red Blood Cell Transfusion on the Immune-Inflammatory Response After Colorectal Cancer Resection

Cytokines play an important role in the acute-phase response to trauma. Few studies have analyzed the effects of allogeneic blood transfusion containing packed red blood cells (RBCs) on the early postoperative immune/inflammatory response after colorectal resection for cancer This study investigated whether allogeneic RBC transfusion influences the postoperative immune/inflammatory response of patients submitted to large bowel resection due to cancer. A total of 26 patients—15 men and 11 women, with a median age of 56.5 years (range 24–87 years)—were prospectively studied. Blood samples were obtained preoperatively and on the first and fourth postoperative days for C-reactive protein (CRP), interleukin-6 (IL-6), and IL-10 assays and for CD4 and CD8 lymphocyte counts. Transfused (≥3 and <3 units), and nontransfused patients were compared. Both IL-6 and IL-10 increased postoperatively in transfused patients (p < 0.01). The serum IL-6 level was higher in patients receiving ≥3 units of RBCs (p < 0.01). CRP increased postoperatively unrelated to blood transfusion. The CD8 count decreased (p < 0.04) in transfused subjects, whereas CD4 decreased (p < 0.01) only in major-transfusion patients. Perioperative allogeneic RBC transfusion enhances the inflammatory systemic response and decreased immunity in patients submitted to colorectal resection for cancer.