Leukocyte Depletion and Transfusion-Induced Immunomodulation

  • Darrell J. Triulzi
  • Neil Blumberg
Part of the Medical Intelligence Unit book series (MIUN)

Summary

The paradigm related to the immunologic consequences of allogeneic blood transfusions has been extended from humoral allosensitization to the effects of transfusion on cellular immune function. This includes down-regulation of effector cells, activation of latent viral infection, and the prolonged circulation of donor immunocompetent cells, as seen in graft-versus-host disease (GVHD).

In addition, there are now extensive data showing conclusively that allogeneic transfusions are associated with enhanced renal allograft tolerance, increased risks of cancer recurrence rates (about 80% in colorectal cancer) and postoperative bacterial infections (as much as 200–1000% in some studies). Whether these last two associations are causal or not remains in doubt although convincing animal data exist for all three outcomes. These associations are most likely in part due to immune modulation caused by transfusion, perhaps augmented by the effects of hemorrhage, anesthesia, and surgical stress.

The most likely mechanism underlying transfusion-induced immunosuppression is anergy due to presentation of large amounts of antigen through the intravenous route. This favors presentation of antigen by “non-professional” antigen presenting cells, a situation that usually leads to anergy or tolerance rather than immune activation. For some years it has been thought that transfused allogeneic white cells are the major mediator of transfusion induced immunomodulation. Results from animal and clinical studies strongly support this possibility. Results of some initial interventional studies, employing autologous transfusions or leukodepletion of allogeneic donor blood suggest that relatively simple, cost effective strategies to ameliorate these complications may be suitable for application in the near future.

Keywords

Filtration Leukemia Citrate Heparin Anemia 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Opelz G, Sengar DPS, Mickey MR, Terasaki PI. Effect of blood transfusions on subsequent kidney transplants. Transplant Proc 5: 253, 1973.PubMedGoogle Scholar
  2. 2.
    Glass NR, Miller DT, Sollinger HW, et al. Comparative analysis of the DST and Immuran-plus-DST protocol for live donor renal transplantation. Transplantation 36:636, 1983;Google Scholar
  3. 3.
    Burrows L, Tartter P. Effect of blood transfusions on colonic malignancy recurrence rate (letter). Lancet 2: 662, 1982.PubMedCrossRefGoogle Scholar
  4. 4.
    Horimi T, Terasaki PI, Chia D, Sasaki N. Factors influencing the paradoxical effect of transfusions on kidney transplants. Transplantation 35: 320, 1983.PubMedCrossRefGoogle Scholar
  5. 5.
    Opelz G. The role of HLA matching and blood transfusions in the cyclosporine era. Transplant Proc 21: 609, 1989.PubMedGoogle Scholar
  6. 6.
    Ahmed Z, Terasaki P. Effect of Transfusions. In: Terasaki PI, Cecka JM (eds)• Clinical Transplants 1991. Los Angeles, CA, UCLA Tissue Typing Laboratory; 305, 1992.Google Scholar
  7. 7.
    Kormos RL, Colson YL, Hardesty RL, et al. Immunologic and blood group compatibility in cardiac transplantation. Transplant Proc 20: 741, 1988.Google Scholar
  8. 8.
    Lavee J, Kormos RL, Duquesnoy RJ, et al. Influence of panel-reactive antibody and lymphocytotoxic crossmatch on survival after heart transplantation. J Heart Lung Transplant 10: 921, 1991.PubMedGoogle Scholar
  9. 9.
    Festenstein H, Banner N, Smith J, et al. The influence of HLA matching and lymphocytotoxic antibody status in heart-lung allograft recipients receiving cyclosporine and azathioprine. Transplant Proc 21: 797, 1989.PubMedGoogle Scholar
  10. 10.
    Gordon RJ, Fung JJ, Markus B, et al. The antibody crossmatch in liver transplantation. Surgery 100: 705, 1986.PubMedGoogle Scholar
  11. 11.
    Marino IR, Weber T, Esquivel CO, Kang YG, Starzl TE, Duquesnoy RJ. Intraoperative blood transfusion requirements and deficient hemostasis in highly alloimmunized patients undergoing liver transplantation. Transplant Proc 20: 1087, 1988.PubMedGoogle Scholar
  12. 12.
    Triulzi DJ, Blumberg N, Heal JM. Association of transfusion with postoperative bacterial infection. CRC Crit Rev Clin Lab Sci 28: 95, 1990.CrossRefGoogle Scholar
  13. 13.
    Tartter PI, Driefuss RM, Malon AM, Heimann TM, Aufses AH. Relationship of postoperative septic complications and blood transfusions in patients with Crohn’s disease. Am J Surg 155: 43, 1988.PubMedCrossRefGoogle Scholar
  14. 14.
    Tartter PI. Blood transfusion and infectious complications following colorectal cancer surgery. Br J Surg 75: 789, 1988.PubMedCrossRefGoogle Scholar
  15. 15.
    Jensen LS, Andersen A, Fristrup SC, et al. Comparison of one dose versus three doses of prophylactic antibiotics, and the influence of blood transfusion, on infectious complications in acute and elective colorectal surgery. Br J Surg 77: 513, 1990.PubMedCrossRefGoogle Scholar
  16. 16.
    Wobbes T, Bemelmans BLH, Kuypers JHC, Beerthuizen GIJM, Theeuwes AGM: Risk of postoperative septic complications after abdominal surgical treatment in relation to perioperative blood transfusion. Surg Gynecol Obstet 171: 59, 1990.PubMedGoogle Scholar
  17. 17.
    Pinto V, Baldonedo R, Nicolas C, Barez A, Perez A, Aza J. Relationship of transfusion and infectious complications after gastric carcinoma operations. Transfusion 31: 114, 1991.PubMedCrossRefGoogle Scholar
  18. 18.
    Braga M, Vignali A, Radaelli G, Gianotti L, Di Carlo V. Association between perioperative blood transfusion and postoperative infection in patients having elective operations for gastrointestinal cancer. Eur J Surg 158: 531, 1992.PubMedGoogle Scholar
  19. 19.
    Jensen LS, Andersen AJ, Christiansen PM, et al. Postoperative infection and natural killer cell function following blood transfusion in patients undergoing elective colorectal surgery. Br J Surg 79: 513, 1992.PubMedCrossRefGoogle Scholar
  20. 20.
    Busch ORC, Hop WCJ, Hoynck van Papendrecht MAW, Marquet RL, Jeekel J. Blood transfusions and prognosis in colorectal cancer. N Engl J Med 328: 1372, 1993.PubMedCrossRefGoogle Scholar
  21. 21.
    Ford CD, VanMoorleghem G, Menlove RL. Blood transfusions and postoperative wound infection. Surgery 113: 603, 1993.PubMedGoogle Scholar
  22. 22.
    George SM, Fabian TC, Voeller GR, Kudsk KA, Mangiante EC, Britt LG. Primary repair of colon wounds A prospective trial in nonselected patients. Ann Surg 209: 728, 1989.PubMedCrossRefGoogle Scholar
  23. 23.
    Dellinger EP, Oreskovich MR, Wertz MJ, Hamasaki V, Lennard ES. Risk of infection following laparotomy for penetrating abdominal injury. Arch Surg 119: 20, 1984.PubMedCrossRefGoogle Scholar
  24. 24.
    Nichols RL, Smith JW, Klein DB, et al. Risk of infection after penetrating abdominal trauma. N Engl J Med 311: 1065, 1984.PubMedCrossRefGoogle Scholar
  25. 25.
    Dawes LG, Aprahamian C, Condon RE, Malangoni MA. The risk of infection after colon injury. Surgery 100: 796, 1986.PubMedGoogle Scholar
  26. 26.
    Rosemurgy AS, Hart MB, Murphy CG, et al. Infection after injury: Association with blood transfusion. Am Surgeon 58: 104, 1992.PubMedGoogle Scholar
  27. 27.
    Agarwal N, Murphy JG, Cayten CG, Stahl WM. Blood transfusion increases the risk of infection after trauma. Arch Surg 128: 171, 1993.PubMedCrossRefGoogle Scholar
  28. 28.
    Edna T-H, Bjerkeset T. Association between blood transfusion and infection in injured patients. J Trauma 33: 659, 1992.PubMedCrossRefGoogle Scholar
  29. 29.
    Nichols RL, Smith JW, Robertson GD, et al. Prospective alterations in therapy for penetrating abdominal trauma. Arch Surg 128: 55, 1993.PubMedCrossRefGoogle Scholar
  30. 30.
    Miholic J, Hudec M, Domanig E, et al. Risk factors for severe bacterial infections after valve replacement and aortocoronary bypass operations: Analysis of 246 cases by logistic regression. Ann Thorac Surg 40: 224, 1985.PubMedCrossRefGoogle Scholar
  31. 31.
    Ottino G, DePaulis R, Pansini S, et al. Major sternal wound infection after open-heart surgery: a multivariate analysis of risk factors in 2579 consecutive operative procedures. Ann Thorac Surg 44: 173, 1987.PubMedCrossRefGoogle Scholar
  32. 32.
    Loop FD, Lytle BW, Cosgrove DM, et al. Sternal wound complications after isolated coronary artery bypass grafting: Early and late mortality, morbidity, and cost of care. Ann Thorac Surg 49: 179, 1990.PubMedCrossRefGoogle Scholar
  33. 33.
    Verwaal VJ, Wobbes T, Koopman-van Gemert AWMM, Buskens FGM, Theeuwes AGM. Effect of perioperative blood transfusion and cell saver on the incidence of postoperative infective complications in patients with an aneurysm of the abdominal aorta. Eur J Surg 158: 477, 1992.PubMedGoogle Scholar
  34. 34.
    Murphy PJ, Connery C, Hicks GL,Jr, Blumberg N. Homologous blood transfusion as a risk factor for postoperative infection after coronary artery bypass graft operations. J Thorac Cardiovasc Surg 104: 1092, 1992.Google Scholar
  35. 35.
    Böck M, Grevers G, Koblitz M, Heim MU, Mempel W. Influence of blood transfusion on recurrence, survival and postoperative infections of laryngeal cancer. Acta Otolaryngol (Stockholm) 110: 155, 1990.CrossRefGoogle Scholar
  36. 36.
    Robbins KT, Favrot S, Hanna D, Cole R. Risk of wound infection in patients with head and neck cancer. Head and Neck 12: 143, 1990.PubMedCrossRefGoogle Scholar
  37. 37.
    von Doersten P, Cruz RM, Selby JV, Hilsinger RL,Jr. Transfusion, recurrence, and infection in head and neck cancer surgery. Otolaryngol Head Neck Surg 106: 60, 1992.Google Scholar
  38. 38.
    Weber RS, Hankins P, Rosenbaum B, Raad I. Nonwound infections following head and neck oncologic surgery. Laryngoscope 103: 22, 1993.PubMedGoogle Scholar
  39. 39.
    Dellinger EP, Miller SD, Wertz MJ, et al. Risk of infection after open fracture of the arm or leg. Arch Surg 123: 1320, 1988.PubMedCrossRefGoogle Scholar
  40. 40.
    Murphy P, Heal JM, Blumberg N. Infection or suspected infection after hip replacement surgery with autologous or homologous transfusions. Transfusion 31: 212, 1991.PubMedCrossRefGoogle Scholar
  41. 41.
    Fernandez MC, Gottlieb M, Menitove JE. Blood transfusion and postoperative infection in orthopedic patients. Transfusion 32: 318, 1992.PubMedCrossRefGoogle Scholar
  42. 42.
    Triulzi DJ, Vanek K, Ryan DH, Blumberg N. A clinical and immunologic study of blood transfusion and postoperative bacterial infection in spinal surgery. Transfusion 32: 517, 1992.PubMedCrossRefGoogle Scholar
  43. 43.
    Graves TA, Cioffi WG, Mason Jr AD, et al. Relationship of transfusion and infection in a burn population. J Trauma 29: 948, 1989.PubMedCrossRefGoogle Scholar
  44. 44.
    Mezrow CK, Bergstein I, Tartter PI. Postoperative infections following autologous and homologous blood transfusions. Transfusion 32: 27, 1992.PubMedCrossRefGoogle Scholar
  45. 45.
    Chiu P, Roy PD, Marshall JC. Blood transfusion is a risk factor for ICU-acquired infection and the multiple organ dysfunction syndrome. Critical Care Med 21(Supplement): S226, 1993-(Abstract).Google Scholar
  46. 46.
    Heiss MM, Mempel W, Jauch KW, Delanoff C, Mayer G, Mempel M, Eissner H-J, Schildberg FW. Beneficial effect of autologous blood transfusion on infectious complications after colorectal cancer surgery. Lancet 342: 1328, 1993.PubMedCrossRefGoogle Scholar
  47. 47.
    Waymack JP, Gallon L, Barcelli U, etal. Effect of blood transfusions on immune function. Arch Surg 122: 56, 1987.PubMedCrossRefGoogle Scholar
  48. 48.
    Waymack JP, Warden GD, Alexander JW, et.al. Effect of blood transfusion and anesthesia on resistance to bacterial peritonitis. J Surg Res 42: 528, 1987.PubMedCrossRefGoogle Scholar
  49. 49.
    Waymack JP, Miskell P, Gonce S. Alterations in host defense associated with inhalation anesthesia and blood transfusion. Anesth Analg 69: 163. 1989.PubMedCrossRefGoogle Scholar
  50. 50.
    Gianotti L, Pyles T, Alexander JW, Babcock GF, Carey MA. Impact of blood transfusion and burn injury on microbial translocation and bacterial survival. Transfusion 32: 312, 1992.PubMedCrossRefGoogle Scholar
  51. 51.
    Gianotti L, Pyles T, Alexander JW, Fukushima R, Babcock GF. Identification of the blood component responsible for increased susceptibility to gut-derived infection. Transfusion 33: 458, 1993.PubMedCrossRefGoogle Scholar
  52. 52.
    Goldman M, Frame B, Singal DP, Blajchman MA. Effect of blood transfusion on survival in a mouse bacterial peritonitis model. Transfusion 31: 710, 1991.PubMedCrossRefGoogle Scholar
  53. 53.
    Cué JI, Peyton JC, Malangoni MA. Does blood transfusion or hemorrhagic shock induce immunosuppression? J Trauma 32: 613, 1992.PubMedCrossRefGoogle Scholar
  54. 54.
    Brunson ME, Ing R, Tchervenkov JI, Alexander JW. Variable infection risk following allogeneic blood transfusions. J Surg Res 48: 308, 1990.PubMedCrossRefGoogle Scholar
  55. 55.
    George CD, Pietsch JD, Byck DC, Shields RE, Polk HC. Effect of blood transfusion on host susceptibility to bacterial infection. Br J Surg 74: 537, 1987 (Abstract).Google Scholar
  56. 56.
    Oikawa T, Hosokawa M, Imamura M, et al. Anti-tumour immunity by normal allogeneic blood transfusion in rat. Clin Exp Immunol 27: 549, 1977.PubMedGoogle Scholar
  57. 57.
    Parrott NR, Lennard TWJ, Proud G, et al. Blood transfusion and surgery: the effect on growth of a syngeneic sarcoma. Ann R Coll Surg Engl 72: 77, 1990.PubMedGoogle Scholar
  58. 58.
    Waymack JP, Fernandes G, Yurt RW, et al. Effect of blood transfusions on immune function Part VI Effect on immunologic response to tumor. Surgery 108: 172, 1990.PubMedGoogle Scholar
  59. 59.
    Shirwadkar S, Blajchman MA, Frame B, Singal DP. Effect of allogeneic blood transfusion on solid tumor growth and pulmonary metastases in mice. J Cancer Res Clin Oncol 118: 176, 1992.PubMedCrossRefGoogle Scholar
  60. 60.
    Jones RDM, Moore GJ, Bacon-Shone J. An investigation of the enhancement of tumour growth by blood transfusion. Med Sci Res 20: 423, 1992.Google Scholar
  61. 61.
    Domasu S, Terada N, Sano H, Kodama M. The effect of blood transfusion on immunological response in mice. Nippon Geka Gakkai 72sshi 93: 1, 1992.Google Scholar
  62. 62.
    Blajchman MA, Bardossy L, Carmen R, Sastry A, Singal DP. Allogeneic blood transfusion-induced enhancement of tumor growth: two animal models showing amelioration by leukodepletion and passive transfer using spleen cells. Blood 81: 1880, 1993.PubMedGoogle Scholar
  63. 63.
    Ichikura T, Tamakuma S, Ito H, Tomimatsu S, Valeri CR. Effects of syngeneic preserved blood cells on metastatic growth of the Lewis lung carcinoma. Nippon Geka Gakkai Zasshi-Journal of the Japanese Surgical Society 92: 734, 1991.Google Scholar
  64. 64.
    Nakano K, Sagara N, Inufusa H, et al. The effect of blood transfusion on tumor growth and metastasis formation. Hum Cell 2: 304, 1989.PubMedGoogle Scholar
  65. 65.
    Waymack JP, Chance WT. Effect of blood transfusions on immune function. IV. Effect on tumor growth. J Surg Oncol 39: 159, 1988.PubMedCrossRefGoogle Scholar
  66. 66.
    Ninomiya M. Study on the induction of immunologic suppression by blood transfusion. J Japan Surg Soc (Nippon Geh Gakkai 7asshi) 87: 1380, 1986.Google Scholar
  67. 67.
    Singh SK, Marquet RL, Westbroek DL, Jeekel J. Abrogation of the tumor promoting effect of allogeneic blood transfusion by polyadenylic-polyuridylic acid (poly A-poly U). Cancer Immunol Immunother 25: 242, 1986.Google Scholar
  68. 68.
    Jakobisiak M, Wlodarski K, Lasek W, Górecki D, Plodziszewska M. Transfusions of syngeneic blood do not seem to induce suppressive effects on antitumor or transplantation immunity in mice. Arch Immunol Therap Exper 33: 543, 1985.Google Scholar
  69. 69.
    Clarke PJ, Tarin D. Effect of preoperative blood transfusion on tumour metastases. Br J Surg 74: 520, 1987.PubMedCrossRefGoogle Scholar
  70. 70.
    Judson RT, Robb L, D’Apice AJF. Blood transfusion and tumour growth: an experimental study. Aust N Z J Surg 55: 503, 1985.PubMedCrossRefGoogle Scholar
  71. 71.
    Singh SK, Marquet RL, Westbroek DL, Jeekel J. Enhanced growth of artificial tumor metastases following blood transfusion: the effect of erythrocytes, leukocytes and plasma transfusion. Eur J Cancer Clin Oncol 23: 1537, 1987.PubMedCrossRefGoogle Scholar
  72. 72.
    Horimi T, Kagawa S, Ninomiya M, Yoshida E, Hiramatsu S, Orita K. Possible induction by blood transfusion of immunological tolerance against growth of transplanted tumors in mice. Acta Med Okayama 37: 259, 1983.PubMedGoogle Scholar
  73. 73.
    Francis DMA, Shenton BK. Blood transfusion and tumour growth: evidence from laboratory animals. Lancet ii 871, 1981 (Letter).Google Scholar
  74. 74.
    Marquet RL, de Bruin RWF, Dallinga RJ, Singh SK, Jeekel J. Modulation of tumor growth by allogeneic blood transfusion. J Cancer Res Clin Oncol 111: 50, 1986.PubMedCrossRefGoogle Scholar
  75. 75.
    Francis DMA, Burren CP, Clunie GJA. Acceleration of B16 melanoma growth in mice after blood transfusion. Surgery 102: 485, 1987.PubMedGoogle Scholar
  76. 76.
    Lenhard V, Scholler P, Zeller W. Transfusion-induced T suppressor cell activity and experimental tumor growth. Transplant Proc 21: 580, 1989.PubMedGoogle Scholar
  77. 77.
    Francis DMA, Shenton BK, Proud G, Taylor RMR. Tumor growth and blood transfusion. J Exp Clin Cancer Res 1: 121, 1982.Google Scholar
  78. 78.
    Lieberman MD, Shou J, Sigal RK, Yu J, Goldfine J, Daly JM. Transfusion-induced immunosuppression results in diminished host survival in a murine neuroblastoma model. J Surg Res 48: 498, 1990.PubMedCrossRefGoogle Scholar
  79. 79.
    Hilgard P, Thornes RD. Anticoagulants in the treatment of cancer. Eur J Cancer 12: 755, 1976.PubMedGoogle Scholar
  80. 80.
    Blumberg N, Heal JM. Transfusion and host defenses against cancer recurrence and infection. Transfusion 29: 236, 1989.PubMedCrossRefGoogle Scholar
  81. 81.
    Tartter PI. Does blood transfusion predispose to cancer recurrence? Am J Clin Oncol 12: 169, 1989.PubMedCrossRefGoogle Scholar
  82. 82.
    Blumberg N, Triulzi DJ, Heal JM. Transfusion-induced immunomodulation and its clinical consequences. Transf Med Rev IV. 24, 1990.Google Scholar
  83. 83.
    Francis DMA. Relationship between blood transfusion and tumour behaviour. Br J Surg 78: 1420, 1991.PubMedCrossRefGoogle Scholar
  84. 84.
    Chung M, Steinmetz OK, Gordon PH. Perioperative blood transfusion and outcome after resection for colorectal carcinoma. Br J Surg 80: 427, 1993.PubMedCrossRefGoogle Scholar
  85. 85.
    Burrows L, Tartter P, Aufses A. Increased recurrence rates in perioperatively transfused colorectal malignancy patients. Cancer Detect Prey 10: 361, 1987.Google Scholar
  86. 86.
    Blumberg N, Agarwal M, Chuang C. Relation between recurrence of cancer of the colon and blood transfusion. Br Med J 290: 1037, 1985.CrossRefGoogle Scholar
  87. 87.
    Foster RS., Costanza MC, Foster JC, et al. Adverse relationship between blood transfusions and survival after colectomy for colon cancer. Cancer 55: 1195, 1985.PubMedCrossRefGoogle Scholar
  88. 88.
    Corman J, Arnoux R, Peloquin A, et.al. Blood transfusions and survival after colectomy for colorectal cancer. Can J Surg 29: 325, 1986.PubMedGoogle Scholar
  89. 89.
    Parrott NR, Lennard TWJ, Taylor RMR, et al. Effect of perioperative blood transfusion on recurrence of colorectal cancer. Br J Surg 73: 970, 1986.PubMedCrossRefGoogle Scholar
  90. 90.
    Voogt PJ, Van de Velde CJH, Brand A, et al. Perioperative blood transfusion and cancer prognosis Different effects of blood transfusion on prognosis of colon and breast cancer patients. Cancer 59: 836, 1987.PubMedCrossRefGoogle Scholar
  91. 91.
    Creasy TS, Veitch PS, Bell PR. A relationship between perioperative blood transfusion and recurrence of carcinoma of the sigmoid colon following potentially curative surgery. Ann R Coll Surg Engl 69: 100, 1987.PubMedGoogle Scholar
  92. 92.
    Ota D, Alvarez L, Lichtiger B, et al. Perioperative blood transfusions in patients with colon carcinoma. Transfusion 25: 392, 1985.PubMedCrossRefGoogle Scholar
  93. 93.
    Weiden PL, Bean MA, Schultz P. Peri-operative blood transfusion does not increase risk of colorectal cancer recurrence. Cancer 60: 870, 1987.PubMedCrossRefGoogle Scholar
  94. 94.
    Frankish PD, McNee RK, Alley PG, Woodfield DG. Relation between cancer of the colon and blood transfusion (letter). Br Med J 290: 1827, 1985.CrossRefGoogle Scholar
  95. 95.
    Francis DMA, Judson RT. Blood transfusion and recurrence of cancer of the colon and rectum. Br J Surg 74: 26, 1987.PubMedCrossRefGoogle Scholar
  96. 96.
    Nathanson SD, Tilley BC, Schultz L, Smith RF. Perioperative allogeneic blood transfusions—survival in patients with resected carcinomas of the colon and rectum. Arch Surg 120: 734, 1985.PubMedCrossRefGoogle Scholar
  97. 97.
    Ross WB. Blood transfusion and colorectal cancer. J R Coll Surg Edinb 32: 197, 1987.PubMedGoogle Scholar
  98. 98.
    Waymack JP, Moomaw CJ, Popp MB. The effect of perioperative blood transfusions on long-term survival of colon cancer patients. Milk Med 154: 515, 1989.Google Scholar
  99. 99.
    Mecklin JP, Jarvinen HJ, Ovaska JT. Blood transfusion and prognosis in colorectal carcinoma. Scand J Gastroenterol 24: 33, 1989.PubMedCrossRefGoogle Scholar
  100. 100.
    Vente JP, Wiggers TH, Weidema WF, et al. Perioperative blood transfusions in colorectal cancer. Eur J Surg Oncol 15: 371, 1989.PubMedGoogle Scholar
  101. 101.
    Beynon J, Davies PW, Biol. M, et al. Perioperative blood transfusion increases the risk of recurrence in colorectal cancer. Dis Colon Rectum 32: 975, 1989.PubMedCrossRefGoogle Scholar
  102. 102.
    Wobbes T, Joosen KHG, Kuypers HHC, Beerthuizen GIJM, Theeuwes AGM: The effect of packed cells and whole blood trans-effect of packed cells and whole blood transfusions on survival after curative resection for colorectal carcinoma. Dis Colon Rectum 32: 743, 1989.PubMedCrossRefGoogle Scholar
  103. 103.
    Marsh J, Donnan PT, Hamer-Hodges DW. Association between transfusion with plasma and the recurrence of colorectal carcinoma. Br J Surg 77: 623, 1990.PubMedCrossRefGoogle Scholar
  104. 104.
    Modin S, Karlsson G, Wählby L. Blood transfusion and recurrence of colorectal cancer. Eur J Surg 158: 371, 1992.PubMedGoogle Scholar
  105. 105.
    Jahnson S, Andersson M. Adverse effects of perioperative blood transfusion in patients with colorectal cancer. Eur J Surg 158: 419, 1992.PubMedGoogle Scholar
  106. 106.
    Tartter PI. The association of perioperative blood transfusion with colorectal cancer recurrence. Ann Surg 216: 633, 1992.PubMedCrossRefGoogle Scholar
  107. 107.
    Liewald F, Wirsching RP, Zülke C, Demmel N, Mempel W. Influence of blood transfusions on tumor recurrence and survival rate in colorectal carcinoma. Eur J Cancer 26: 327, 1990.PubMedCrossRefGoogle Scholar
  108. 108.
    Crowson MC, Hallissey MT, Kiff RS, Kingston RD, Fielding JWL. Blood transfusion in colorectal cancer. Br J Surg 76: 522, 1989.PubMedCrossRefGoogle Scholar
  109. 109.
    Jakobsen EB, Eickhoff JH, Andersen J, Lundvall L, Stenderup JK. Perioperative blood transfusion and recurrence and death after resection for cancer of the colon and rectum. Scand J Gastroenterol 25: 435, 1990.PubMedCrossRefGoogle Scholar
  110. 110.
    Onodera H, Maetani S, Tobe T. Effect of blood transfusion on prognosis of colorectal cancer patients. J Japan Surg Soc (Nippon Geka Gakkai 7asshi) 90: 1890, 1989.Google Scholar
  111. 111.
    Bentzen SM, Balslev I, Pedersen M, et al. Blood transfusion and prognosis in Dukes’ B and C colorectal cancer. Eur J Cancer 26: 457, 1990.PubMedCrossRefGoogle Scholar
  112. 112.
    Van Lawick van Pabst WP, Langenhorst BLAM, Mulder PGH, Marquet RL, Jeekel J. Effect of perioperative blood loss and perioperative blood transfusions on colorectal cancer survival. Eur J Cancer Clin Oncol 24: 741, 1988.CrossRefGoogle Scholar
  113. 113.
    Cheslyn-Curtis S, Fielding LP, Hittinger R, Fry JS, Phillips RKS. Large bowel cancer: the effect of perioperative blood transfusion on outcome. Ann R Coll Surg Engl 72: 53, 1990.PubMedGoogle Scholar
  114. 114.
    Werner C, Nielsen J, Ottesen SS. The significance of blood transfusion for recurrence after colorectal cancer surgery. Ug Laeger 150: 3182, 1988.Google Scholar
  115. 115.
    Zimmerman T, Dobroschke J, Borowek U, Padberg W. Effect of perioperative allogenic blood transfusion on prognosis of colorectal cancer. Zent bi Chir 116: 1125, 1991.Google Scholar
  116. 116.
    Tang R, Wang JY, Chien CRC, Chen JS, Lin SE, Fan HA. The association between perioperative blood transfusion and survival of patients with colorectal cancer. Cancer 1993; 72: 341–348.PubMedCrossRefGoogle Scholar
  117. 117.
    Fuhrman GM, Davidson BS, Larach SW, Williamson PR. Analysis of local recurrence of midrectal cancer after low anterior resection and stapled anastomosis. Southern Med J 85: 502, 1992.PubMedCrossRefGoogle Scholar
  118. 118.
    Kjems E, Schydlowski P, Sqndergaard JO. The influence of blood transfusions upon the recurrence rate of colorectal cancer. Rev Med Chir Soc Med Nat IASI 95: 265, 1991.PubMedGoogle Scholar
  119. 119.
    Arnoux R, Corman J, Péloquin A, Smeesters C, St-Louis G. Adverse effect of blood transfusions on patient survival after resection of rectal cancer. Can J Surg 31: 121, 1988.PubMedGoogle Scholar
  120. 120.
    Faenza A, Cunsolo A, Selleri S, Lucarelli S, Farneti PA, Gozzetti G. Correlation between plasma or blood transfusion and survival after curative surgery for colorectal cancer. Int Surg 77: 264, 1992.PubMedGoogle Scholar
  121. 121.
    Fernandez Fernandez L, Sanz Anquela M, Ratia T, et al. Transfusion de Sangre perioperatoria y pronóstico en el cancer colorrectal.Anâlisis de una serie. Rev Esp Enf Digest 82: 317, 1992.Google Scholar
  122. 122.
    Pellicer Franco EM, Olmo G, Parilla Paricio P, Morales Cuenca G, y Prieto A. La transfusion sanguínea ensombrece el pron6stico del cancer colorrectal Estudio preliminar en una serie de 717 casos. Rev Esp Enf Digest 77: 189, 1990.Google Scholar
  123. 123.
    Elorza Orúe JL, Palomar de Luis M, y Tubía Landaberea J. Recidiva del cancer colorrectal y transfusion sanguínea. Rev Esp Enf Digest 82: 150, 1992.Google Scholar
  124. 124.
    Vamvakas E, Moore SB. Perioperative blood transfusion and colorectal cancer recurrence: A qualitative statistical overview and meta-analysis. Transfusion 33: 754, 1993.Google Scholar
  125. 125.
    Amato A, Butti A. Do patients with less advanced colorectal cancers recur more when perioperatively transfused? J Surg Oncol 48[Supplement 2):169, 1993-abstract.Google Scholar
  126. 126.
    Blumberg N, Heal JM, Murphy P, et al. Association between transfusion of whole blood and recurrence of cancer. Br Med J 293: 530, 1986.CrossRefGoogle Scholar
  127. 127.
    Blumberg N, Heal JM, Chuang C, et al. Further evidence supporting a cause and effect relationship between blood transfusion and cancer recurrence. Ann Surg 207: 410, 1988.PubMedCrossRefGoogle Scholar
  128. 128.
    Blumberg N, Chuang-Stein C, Heal JM. The relationship between blood transfusion, tumor staging and cancer recurrence. Transfusion 30: 291, 1990.PubMedCrossRefGoogle Scholar
  129. 129.
    Hermanek Pjr., Guggenmoos-Holzmann I, Schricker KT, et al. The influence of blood and hemoderivatives on the prognosis of colorectal carcinoma. Langenbecks Arch Chir 374: 118, 1989.PubMedCrossRefGoogle Scholar
  130. 130.
    Bordin JO, Bardossy L, Singal DP, Blajchman MA. Lack of efficacy of post-storage leukodepletion of allogeneic blood transfusions in preventing growth enhancement of animal tumors. Blood 82 [Supplement 1):392a, 1993-abstract.Google Scholar
  131. 131.
    Heiss MM, Jauch KW, Delanoff C, Mempel W, Schildberg FW. Blood transfusion modulated tumor recurrence: a randomized study of autologous vs. homologous blood transfusion in colorectal cancer. Proc Annu Meet Am Soc Clin Oncol 11:A503, 1992-Abstract.Google Scholar
  132. 132.
    Oksanen K, Elonen E. Impact of leukocyte—depleted blood components on the haematological recovery and prognosis of patients with acute myeloid leukaemia. Br J Haematol 84: 639, 1993.PubMedCrossRefGoogle Scholar
  133. 133.
    Blumberg N, Heal JM. Evidence for plasma-mediated immunomodulation-transfusions of plasma-rich blood components are associated with a greater risk of acquired im-munodeficiency syndrome than transfusions of red blood cells alone. Transplant Proc 20: 1138, 1988.PubMedGoogle Scholar
  134. 134.
    Ward JW, Bush TJ, Perkins HA, et al. The natural history of transfusion-associated infection with human immunodeficiency virus. Factors influencing the rate of progression to disease. N Engl J Med 321: 947, 1989.PubMedCrossRefGoogle Scholar
  135. 135.
    Vamvakas E, Kaplan HS. Early transfusion and length of survival in AIDS: experience with a population receiving medical care at a public hospital. Transfusion 33: 111, 1993.PubMedCrossRefGoogle Scholar
  136. 136.
    Preiksaitis JK, Brown L, McKenzie M. The risk of cytomegalovirus infection in seronegative transfusion recipients not receiving exogenous immunosuppression. J Infect Dis 157: 523, 1988.PubMedCrossRefGoogle Scholar
  137. 137.
    Adler SP, McVoy MM. Cytomegalovirus infections in seropositive patients after transfusion The effect of red cell storage and volume. Transfusion 29: 667, 1989.PubMedCrossRefGoogle Scholar
  138. 138.
    Cheung KS, Lang DJ. Transmission and activation of cytomegalovirus with blood transfusion: a mouse model. J Infect Dis 135: 841, 1977.PubMedCrossRefGoogle Scholar
  139. 139.
    Lang DJ, Ebert PA, Rodgers BM, Boggess HP, Rixse RS. Reduction of postperfusion CMV infections following the use of leukocyte depleted blood. Transfusion 17: 391, 1977.PubMedCrossRefGoogle Scholar
  140. 140.
    Thompson KS, Plapp FV, Long ND, Heenan TA. CMV infection in heart transplant recipients. Transfusion 32 (Supplement): 65S, 1992.Google Scholar
  141. 141.
    Busch MP, Lee T-H, Heitman J. Allogeneic leukocytes but not therapeutic blood elements induce reactivation and dissemination of latent HIV-1 infection: implications for transfusion support of infected patients. Blood 80: 2128, 1992.PubMedGoogle Scholar
  142. 142.
    Ford CD, Warnick CT, Sheets S, et al. Blood transfusions lower natural killer cell activity. Transplant Proc 9: 1456, 1987.Google Scholar
  143. 143.
    Bruggeman CA. Reactivation of latent CMV in the rat. Transplant Proc 23 (Supplement 3): 22, 1991.PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1995

Authors and Affiliations

  • Darrell J. Triulzi
  • Neil Blumberg

There are no affiliations available

Personalised recommendations