COMPARATIVE-STUDY OF THE IMMUNOLOGICAL EFFECTS OF AUTOLOGOUS AND HOMOLOGOUS TRANSFUSION IN PATIENTS UNDERGOING LUNG-CANCER SURGERY

A study was carried out to determine the effects of tranfusion with ei ther autologous or homologous blood in 35 patients with lung cancer un dergoing lung surgery. The patients were randomly allocated to two gro ups, << allo >> receiving homologous blood (n = 10), and << auto >> re ceiving autologous blood only (n = 13). A third control group included the patients (n = 12) who had not required any blood. In patients of << auto >> group, two blood removals of 7 ml . kg-1 each were performe d, provided their haemoglobin concentration was over 110 g . l-1 and t heir haematocrit over 34 %. The following parameters were studied at t -1 (the day of inclusion), t0 (just before surgery and transfusion), t 1 (one week after surgery). and t2 (one month later) : haematocrit and haemoglobin concentration: IgG, IgA and IgM concentrations ; polymorp honuclear and neutrophil leucocyte and lymphocyte numbers, lymphocyte subpopulations (CD4/CD8), activated natural killers (NK), polymorphonu clear leukocyte chemotaxis and chemoluminescence. Anaesthesia and surg ery initiated initiated an early decrease in immunity in all three gro ups. The immune profile, and its time course in patients who received autologous blood only was similar to that of those who were not transf used at all. On the other hand, homologous blood transfusion seems to modify the recipient's non specific immune system. In group << allo >> , a decrease occurred in the number of auxillary lymphocytes CD4, an i ncrease in suppressor lymphocyte numbers CD8, with an increase in the CD4/CD8 ratio, and no increase in NK activity. These data suggest that autologous transfusion is well tolerated in cancer patients undergoin g surgery.