The Impact of Two Different Transfusion Strategies on Patient Immune Response during Major Abdominal Surgery: A Preliminary Report
Blood transfusion is associated with well-known risks. We investigated the difference between a restrictive versus a liberal transfusion strategy on the immune response, as expressed by the production of inflammatory mediators, in patients subjected to major abdominal surgery procedures. Fifty-eight...
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| Format: | Article |
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Wiley
2014-01-01
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| Series: | Journal of Immunology Research |
| Online Access: | http://dx.doi.org/10.1155/2014/945829 |
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| author | Kassiani Theodoraki Maria Markatou Demetrios Rizos Argyro Fassoulaki |
| author_facet | Kassiani Theodoraki Maria Markatou Demetrios Rizos Argyro Fassoulaki |
| author_sort | Kassiani Theodoraki |
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| description | Blood transfusion is associated with well-known risks. We investigated the difference between a restrictive versus a liberal transfusion strategy on the immune response, as expressed by the production of inflammatory mediators, in patients subjected to major abdominal surgery procedures. Fifty-eight patients undergoing major abdominal surgery were randomized preoperatively to either a restrictive transfusion protocol or a liberal transfusion protocol (with transfusion if hemoglobin dropped below 7.7 g dL−1 or 9.9 g dL−1, respectively). In a subgroup of 20 patients randomly selected from the original allocation groups, blood was sampled for measurement of IL-6, IL-10, and TNFα. Postoperative levels of IL-10 were higher in the liberal transfusion group on the first postoperative day (49.82±29.07 vs.
15.83±13.22 pg mL−1, P<0.05). Peak postoperative IL-10 levels correlated with the units of blood transfused as well as the mean duration of storage and the storage time of the oldest unit transfused (r2=0.38, P=0.032, r2=0.52, P=0.007, and r2=0.68, P<0.001, respectively). IL-10 levels were elevated in patients with a more liberal red blood cell transfusion strategy. The strength of the association between anti-inflammatory IL-10 and transfusion variables indicates that IL-10 may be an important factor in transfusion-associated immunomodulation. This trial is registered under ClinicalTrials.gov Identifier: NCT02020525. |
| format | Article |
| id | doaj-art-adb83042a8af439d9d2b65a6ed7e270f |
| institution | Kabale University |
| issn | 2314-8861 2314-7156 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
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| series | Journal of Immunology Research |
| spelling | doaj-art-adb83042a8af439d9d2b65a6ed7e270f2025-08-20T03:39:41ZengWileyJournal of Immunology Research2314-88612314-71562014-01-01201410.1155/2014/945829945829The Impact of Two Different Transfusion Strategies on Patient Immune Response during Major Abdominal Surgery: A Preliminary ReportKassiani Theodoraki0Maria Markatou1Demetrios Rizos2Argyro Fassoulaki3Department of Anesthesiology, Aretaieion University Hospital, 11528 Athens, GreeceDepartment of Anesthesiology, Aretaieion University Hospital, 11528 Athens, GreeceHormonal and Biochemical Laboratory, Aretaieion University Hospital, 11528 Athens, GreeceDepartment of Anesthesiology, Aretaieion University Hospital, 11528 Athens, GreeceBlood transfusion is associated with well-known risks. We investigated the difference between a restrictive versus a liberal transfusion strategy on the immune response, as expressed by the production of inflammatory mediators, in patients subjected to major abdominal surgery procedures. Fifty-eight patients undergoing major abdominal surgery were randomized preoperatively to either a restrictive transfusion protocol or a liberal transfusion protocol (with transfusion if hemoglobin dropped below 7.7 g dL−1 or 9.9 g dL−1, respectively). In a subgroup of 20 patients randomly selected from the original allocation groups, blood was sampled for measurement of IL-6, IL-10, and TNFα. Postoperative levels of IL-10 were higher in the liberal transfusion group on the first postoperative day (49.82±29.07 vs. 15.83±13.22 pg mL−1, P<0.05). Peak postoperative IL-10 levels correlated with the units of blood transfused as well as the mean duration of storage and the storage time of the oldest unit transfused (r2=0.38, P=0.032, r2=0.52, P=0.007, and r2=0.68, P<0.001, respectively). IL-10 levels were elevated in patients with a more liberal red blood cell transfusion strategy. The strength of the association between anti-inflammatory IL-10 and transfusion variables indicates that IL-10 may be an important factor in transfusion-associated immunomodulation. This trial is registered under ClinicalTrials.gov Identifier: NCT02020525.http://dx.doi.org/10.1155/2014/945829 |
| spellingShingle | Kassiani Theodoraki Maria Markatou Demetrios Rizos Argyro Fassoulaki The Impact of Two Different Transfusion Strategies on Patient Immune Response during Major Abdominal Surgery: A Preliminary Report Journal of Immunology Research |
| title | The Impact of Two Different Transfusion Strategies on Patient Immune Response during Major Abdominal Surgery: A Preliminary Report |
| title_full | The Impact of Two Different Transfusion Strategies on Patient Immune Response during Major Abdominal Surgery: A Preliminary Report |
| title_fullStr | The Impact of Two Different Transfusion Strategies on Patient Immune Response during Major Abdominal Surgery: A Preliminary Report |
| title_full_unstemmed | The Impact of Two Different Transfusion Strategies on Patient Immune Response during Major Abdominal Surgery: A Preliminary Report |
| title_short | The Impact of Two Different Transfusion Strategies on Patient Immune Response during Major Abdominal Surgery: A Preliminary Report |
| title_sort | impact of two different transfusion strategies on patient immune response during major abdominal surgery a preliminary report |
| url | http://dx.doi.org/10.1155/2014/945829 |
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