COMPARATIVE-STUDY OF THE IMMUNOLOGICAL EFFECTS OF AUTOLOGOUS AND HOMOLOGOUS TRANSFUSION IN PATIENTS UNDERGOING LUNG-CANCER SURGERY

A study was carried out to determine the effects of tranfusion with either autologous or homologous blood in 35 patients with lung cancer undergoing lung surgery. The patients were randomly allocated to two groups, << allo >> receiving homologous blood (n = 10), and << auto >> receiving autologous blood only (n = 13). A third control group included the patients (n = 12) who had not required any blood. In patients of << auto >> group, two blood removals of 7 ml . kg-1 each were performed, provided their haemoglobin concentration was over 110 g . l-1 and their haematocrit over 34 %. The following parameters were studied at t-1 (the day of inclusion), t0 (just before surgery and transfusion), t1 (one week after surgery). and t2 (one month later) : haematocrit and haemoglobin concentration: IgG, IgA and IgM concentrations ; polymorphonuclear and neutrophil leucocyte and lymphocyte numbers, lymphocyte subpopulations (CD4/CD8), activated natural killers (NK), polymorphonuclear leukocyte chemotaxis and chemoluminescence. Anaesthesia and surgery initiated initiated an early decrease in immunity in all three groups. The immune profile, and its time course in patients who received autologous blood only was similar to that of those who were not transfused at all. On the other hand, homologous blood transfusion seems to modify the recipient's non specific immune system. In group << allo >>, a decrease occurred in the number of auxillary lymphocytes CD4, an increase in suppressor lymphocyte numbers CD8, with an increase in the CD4/CD8 ratio, and no increase in NK activity. These data suggest that autologous transfusion is well tolerated in cancer patients undergoing surgery.