POSTOPERATIVE INFLAMMATORY RESPONSE AFTER AUTOLOGOUS AND ALLOGENEIC BLOOD-TRANSFUSION

Background: Allogeneic blood transfusions cause immunosuppression. The aim of this study was to determine whether complement anaphylatoxins, cytokines, or both are released in the recipient, after blood transfu sions in general, and after autologous blood transfusions in particula r. Methods: Thirty-one patients having total hip joint replacement sur gery were randomized to receive either allogeneic red blood cells (n = 15) or predeposited autologous whole blood transfusion (n = 16). Plas ma concentrations of the anaphylatoxins C3a and C5a, the terminal C5b- 9 complement complex, and cytokines IL-6 and IL-8 in the recipients we re repeatedly analyzed before, during, and after surgery. Results: Sig nificantly increased concentrations of IL-6 and IL-8 appeared in both groups, with a significantly greater increase in the autologous blood group. Patients in both groups developed a moderate but significant in crease of C3a without a significant difference between them. C5a and t erminal C5b-9 complement complex were not greatly changed. Conclusions : The study showed a greater increase in cytokine concentration after autologous blood transfusion than after allogeneic blood transfusion. The lower response in the latter may result from transfusion-induced s uppression of cellular immunity.