Erythrocyte transfusion causes immunosuppression after total hip replacement

A prospective study of 34 patients undergoing total hip replacement was don e to determine whether homologous erythrocyte transfusion causes postoperat ive immunosuppression, In the transfused patient group (14 patients), there was a reduction in CD3+ and CD3+4+ cell numbers at Day 2, returning to pre operative levels by Day 7, In contrast, in the untransfused patient group ( 20 patients), there was no significant depression in these lymphocyte subgr oups at Day 2 and an increase in total lymphocyte, CD3+, CD3+4+, and CD3+4- 8- cell numbers at Day 7, In both patient groups there was postoperative le ukocytosis, granulocytosis, and monocytosis at Days 2 and 7, with no signif icant change in postoperative B (CD19+) cell numbers, natural killer cells, or the minor T cell populations of CD3+4+8+ and CD3+25+, The lymphocyte fu nctional test of Candida recall was significantly impaired at Day 7 in the transfused patient group, where Candida recall is a memory T cell response to an antigen extracted from the yeast Candida Albicans, These findings sug gest that homologous erythrocyte transfusion after hip replacement surgery causes cell mediated immune suppression. The main clinical implication of t he current study is that perioperative homologous erythrocyte transfusion m ay place patients at greater risk of infectious complications, including in fection of the prosthesis.