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Received: 2007-04-25

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Journal of Zhejiang University SCIENCE B 2007 Vol.8 No.8 P.560-565


Effect of perioperative autologous versus allogeneic blood transfusion on the immune system in gastric cancer patients

Author(s):  CHEN Gang, ZHANG Feng-jiang, GONG Ming, YAN Min

Affiliation(s):  Department of Anesthesiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China

Corresponding email(s):   yanminnina@hotmail.com

Key Words:  Transfusion-induced immunomodulation (TRIM), Autologous blood transfusion, Allogeneic blood transfusion, Neopterin, Interferon-gamma (IFN-&gamma, ), CD3+, CD4+, CD4+/CD8+ ratio

CHEN Gang, ZHANG Feng-jiang, GONG Ming, YAN Min. Effect of perioperative autologous versus allogeneic blood transfusion on the immune system in gastric cancer patients[J]. Journal of Zhejiang University Science B, 2007, 8(8): 560-565.

@article{title="Effect of perioperative autologous versus allogeneic blood transfusion on the immune system in gastric cancer patients",
author="CHEN Gang, ZHANG Feng-jiang, GONG Ming, YAN Min",
journal="Journal of Zhejiang University Science B",
publisher="Zhejiang University Press & Springer",

%0 Journal Article
%T Effect of perioperative autologous versus allogeneic blood transfusion on the immune system in gastric cancer patients
%A CHEN Gang
%A ZHANG Feng-jiang
%A GONG Ming
%A YAN Min
%J Journal of Zhejiang University SCIENCE B
%V 8
%N 8
%P 560-565
%@ 1673-1581
%D 2007
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.2007.B0560

T1 - Effect of perioperative autologous versus allogeneic blood transfusion on the immune system in gastric cancer patients
A1 - CHEN Gang
A1 - ZHANG Feng-jiang
A1 - GONG Ming
A1 - YAN Min
J0 - Journal of Zhejiang University Science B
VL - 8
IS - 8
SP - 560
EP - 565
%@ 1673-1581
Y1 - 2007
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.2007.B0560

Background: Allogeneic blood )%29&ck%5B%5D=abstract&ck%5B%5D=keyword'>transfusion-induced immunomodulation (TRIM) and its adverse effect on the prognosis of patients treated surgically for cancer remain complex and controversial. However, the potential risk associated with allogeneic blood transfusion has heightened interest in the use of autologous blood transfusion. In the present study, the serum concentrations of neopterin, interferon-gamma (IFN-&gamma;), T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) and a possible association between these variables were investigated. The purpose was to further evaluate the effect of autologous versus allogeneic blood transfusion on immunological status in patients undergoing surgery for gastric cancer. Methods: Sixty ASA I~II (American Society of Anesthesiologists) patients undergoing elective radical resection for stomach cancer were randomly allocated to receive either allogeneic blood transfusion (n=30) or autologous blood transfusion (n=30). Serum concentrations of the neopterin, IFN-γ and T lymphocyte subsets in the recipients were measured before induction of anesthesia, after operation, and on the 5th postoperative day. Results: Both two groups, serum neopterin, IFN-γ, percentages of T-cell subsets (CD3+, CD4+), and CD4+/CD8+ ratio had significantly decreased after operation, but decreased more significantly in group H (receiving allogeneic blood transfusion) than those in group A (receiving autologous whole blood transfusion) (P<0.05). On the 5th postoperative day, serum neopterin, IFN-γ, CD3+, CD4+ T-cells, and CD4+/CD8+ ratio returned to the baseline values in group A. In contrast, the above remain decreasing in group H, where there were no significant relations between serum neopterin and IFN-γ. Conclusion: Perioperative surgical trauma and stress have an immunosuppressive impact on gastric cancer patients. allogeneic blood transfusion exacerbates the impaired immune response. autologous blood transfusion might be significantly beneficial for immune-compromised patients in the perioperative period, clearly showing its superiority over allogeneic blood transfusion.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article


[1] Altindağ, Z.Z., Sahin, G., Inanici, F., Hasçelik, Z., 1998. Urinary neopterin excretion and dihydropteridine reductase activity in rheumatoid arthritis. Rheumatol. Int., 18(3):107-111.

[2] Andersen, B.L., Farrar, W.B., Golden-Kreutz, D., Kutz, L.A., MacCallum, R., Courtney, M.E., Glaser, R., 1998. Stress and immune responses after surgical treatment for regional breast cancer. J. Natl. Cancer Inst., 90(1):30-36.

[3] Angele, M.K., Faist, E., 2002. Clinical review: immunodepression in the surgical patient and increased susceptibility to infections. Crit. Care, 6(4):298-305.

[4] Babcock, G.F., Alexander, J.W., 1996. The effects of blood transfusion on cytokine production by Th1 and Th2 lymphocytes in the mouse. Transplantation, 61(3):465-468.

[5] Bar-Yosef, S., Melamed, R., Page, G.G., Shakhar, G., Shakhar, K., Ben-Eliyahu, S., 2001. Attenuation of the tumor-promoting effect of surgery by spinal blockade in rats. Anesthesiology, 94(6):1066-1073.

[6] Biedler, A.E., Schneider, S.O., Seyfert, U., Rensing, H., Grenner, S., Girndt, M., Bauer, I., Bauer, M., 2002. Impact of alloantigens and storage-associated factors on stimulated cytokine response in an in vitro model of blood transfusion. Anesthesiology, 97(5):1102-1109.

[7] Carless, P., Moxey, A., O'Connell, D., Henry, D., 2004. Autologous transfusion techniques: a systematic review of their efficacy. Transfus. Med., 14(2):123-144.

[8] Chu, R.W., 1999. Leukocytes in blood transfusion: adverse effects and their prevention. HKMJ, 5(3):280-284.

[9] Claas, F.H., Roelen, D.L., van Rood, J.J., Brand, A., 2001. Modulation of the alloimmune response by blood transfusions. Transfus. Clin. Biol., 8(3):315-317.

[10] Heiss, M.M., Merten, K., Allgayer, H., Ströhlein, M.A., Tarabichi, A., Wallner, S., Eissner, H.I., Jauch, K.W., Schildberg, F.W., 1997. Influence of autologous blood transfusion on NK and LAK cell activities in cancer surgery. Vox Sang., 73(4):237-245.

[11] Jin, O., Sun, L.Y., Zhou, K.X., Zhang, X.S., Feng, X.B., Mok, M.Y., Lau, C.S., 2005. Lymphocyte apoptosis and macrophage function: correlation with disease activity in systemic lupus erythematosus. Clin. Rheumatol., 24(2):107-110.

[12] Kirkley, S.A., 1999. Proposed mechanisms of transfusion-induced immunomodulation. Clin. Vaccine Immunol., 6(5):652-657.

[13] Kirkley, S.A., Cowles, J., Pellegrini, V.D., Harris, C.M., Boyd, A.D., Blumberg, N., 1995. Cytokine secretion after allogeneic or autologous blood transfusion. Lancet, 345(8948):527.

[14] Kirkley, S.A., Cowles, J., Pellegrini, V.D., Harris, C.M., Boyd, A.D., Blumberg, N., 1998. Blood transfusion and total joint replacement surgery: T helper 2 (TH2) cytokine secretion and clinical outcome. Transfus. Med., 8(3):195-204.

[15] Kuss, I., Hathaway, B., Ferris, R.L., 2004. Decreased absolute counts of T lymphocyte subsets and their relation to disease in squamous cell carcinoma of the head and neck. Clin. Cancer Res., 10(11):3755-3762.

[16] Lewis, C.E., Hiratzka, L.F., Woods, S.E., Hendy, M.P., Engel, A.M., 2005. Autologous blood transfusion in elective cardiac valve operations. J. Card. Surg., 20(6):513-518.

[17] Lin, H.S., Samy, R.N., Lum, J., Dorie, M.J., Terris, D.J., 2002. Effect of blood transfusion in an experimental sarcoma model. Arch. Otolaryngol. Head Neck Surg., 128(3):308-312.

[18] Melichar, B., Solichova, D., Freedman, R.S., 2006. Neopterin as an indicator of immune activation and prognosis in patients with gynecological malignancies. Int. J. Gynecol. Cancer, 16(1):240-252.

[19] Murr, C., Widner, B., Wirleitner, B., Fuchs, D., 2002. Neopterin as a marker for immune system activation. Curr. Drug Metabol., 3(2):175-187.

[20] Nagao, M., Nakajima, Y., Kanehiro, H., Hisanaga, M., Aomatsu, Y., Ko, S., Tatekawa, Y., Ikeda, N., Kanokogi, H., Urizono, Y., et al., 2000. The impact of interferon gamma receptor expression on the mechanism of escape from host immune surveillance in hepatocellular carcinoma. Hepatology, 32(3):491-500.

[21] Ordemann, J., Jacobi, C.A., Braumann, C., Schwenk, W., Volk, H.D., Muller, J.M., 2002. Immunomodulatory changes in patients with colorectal cancer. Int. J. Colorectal Dis., 17(1):37-41.

[22] Potter, K.J., Gompels, M.M., Langkamer, V.G., Virgo, P.F., Lock, R.J., 2003. Th1 and Th2 subsets in orthopaedic surgery by single-cell cytokine analysis. Clin. Lab., 49(5-6):197-202.

[23] Ray, J.C., Kirschner, D.E., 2006. Requirement for multiple activation signals by anti-inflammatory feedback in macrophages. J. Theor. Biol., 241(2):276-294.

[24] Schneemilch, C.E., Hachenberg, T., Ansorge, S., Ittenson, A., Bank, U., 2005. Effects of different anaesthetic agents on immune cell function in vitro. Eur. J. Anaesthesiol., 22(8):616-623.

[25] Sghiri, R., Feinberg, J., Thabet, F., Dellagi, K., Boukadida, J., Ben Abdelaziz, A., Casanova, J.L., Barbouche, M.R., 2005. Gamma interferon is dispensable for neopterin production in vivo. Clin. Diagn. Lab. Immunol., 12(12):1437-1441.

[26] Vanderlinde, E.S., Heal, J.M., Blumberg, N., 2002. Autologous transfusion. BMJ, 324(7340):772-775.

[27] Wirleitner, B., Reider, D., Ebner, S., Bock, G., Widner, B., Jaeger, M., Schennach, H., Romani, N., Fuchs, D., 2002. Monocyte-derived dendritic cells release neopterin. J. Leukoc. Biol., 72(6):1148-1153.

[28] Yan, M., Chen, G., Fang, L.L., Liu, Z.M., Zhang, X.L., 2005. Immunologic changes to autologous transfusion after operational trauma in malignant tumor patients: neopterin and interleukin-2. J. Zhejiang Univ. Sci. B, 6(1):49-52.

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