TRANSFUSION OF RED-CELLS IS ASSOCIATED WITH INCREASED INCIDENCE OF BACTERIAL-INFECTION AFTER COLORECTAL SURGERY - A PROSPECTIVE-STUDY

BACKGROUND: Several studies suggest that perioperative blood transfusi on is a major independent risk factor for postoperative bacterial infe ctions. Transfusion-induced immunosuppression is thought to mediate th is effect. STUDY DESIGN AND METHODS: In a randomized clinical trial co mprising 697 patients with colorectal cancer, the relationship between two types of red cell components (buffy coat-depleted packed red cell s and white cell-reduced [filtered] packed red cells) and postoperativ e bacterial infections was analyzed. RESULTS: Both types of red cells appeared to be associated with a greater incidence of postoperative in fection than was no transfusion (39 vs. 24%, p<0.01). A dose-response relationship could be demonstrated: the corrected relative risk was 1. 6 for 1 to 3 units of red cells and 3.6 for more than 3 units. Multiva riate analyses identified the transfusion of red cells and turner loca tion as the only significant independent risk factors for postoperativ e bacterial infection. CONCLUSION: Because allogeneic white cells, pla sma, microaggregates, citrate, and platelets could be ruled out as ris k factors for transfusion-associated postoperative infections, it is h ypothesized that the transfusion of red cells is a potentially detrime ntal factor that transiently impairs the clearance of bacteria by phag ocytic cells.