PERIOPERATIVE ALLOGENEIC BLOOD-TRANSFUSION EXACERBATES SURGICAL STRESS-INDUCED POSTOPERATIVE IMMUNOSUPPRESSION AND HAS A NEGATIVE EFFECT ONPROGNOSIS IN PATIENTS WITH GASTRIC-CANCER

The immunomodulative effect of perioperative allogeneic blood transfus ion on host immunocompetence was studied in 109 patients with gastric cancer at various stages. Mitogen-induced lymphocyte blastogenesis, ly mphocyte surface markers (specific for T, B, CD4, and CD8 populations) , and the activity of natural killer (NK) cells were examined before s urgery and then 2 and 4 weeks after surgery. The effects on host immun ocompetence of transfusion alone, in the absence of any effect of surg ical stress, were studied, preoperatively, in nine patients who receiv ed preoperative transfusion. Although a tendency towards a decrease in the posttransfusion activity of NK cells was observed, there were no statistically significant differences between pre- and posttransfusion levels. Mitogen-induced blastogenesis and the activity of NK cells we re significantly impaired 2 weeks after surgery in transfused patients as compared to those in non-transfused patients with gastric cancer a t stage Ill and stage IV, and postoperative survival was significantly lower in transfused as compared to nontransfused patients. These resu lts indicate that perioperative allogeneic blood transfusion exacerbat es surgical stress-induced postoperative immunosuppression and has a n egative effect on prognosis in patients with gastric cancer. (C) 1994 Wiley-Liss, Inc.