Transfusion of red cells is associated with increased incidence of bacterial infection after colorectal surgery: a prospective study.

Abstract

BACKGROUND:

Several studies suggest that perioperative blood transfusion is a major independent risk factor for postoperative bacterial infections. Transfusion-induced immunosuppression is thought to mediate this effect.

STUDY DESIGN AND METHODS:

In a randomized clinical trial comprising 697 patients with colorectal cancer, the relationship between two types of red cell components (buffy coat-depleted packed red cells and white cell-reduced [filtered] packed red cells) and postoperative bacterial infections was analyzed.

RESULTS:

Both types of red cells appeared to be associated with a greater incidence of postoperative infection 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. Multivariate analyses identified the transfusion of red cells and tumor location as the only significant independent risk factors for postoperative bacterial infection.

CONCLUSION:

Because allogeneic white cells, plasma, microaggregates, citrate, and platelets could be ruled out as risk factors for transfusion-associated postoperative infections, it is hypothesized that the transfusion of red cells is a potentially detrimental factor that transiently impairs the clearance of bacteria by phagocytic cells.

• Authors: J G Houbiers, C J van de Velde, L M van de Watering, J Hermans, S Schreuder, A B Bijnen, P Pahlplatz, M E Schattenkerk, T Wobbes, J E de Vries, P Klementschitsch, A H van de Maas, A Brand
• Journal: Transfusion (Transfusion) Vol. 37 Issue 2 Pg. 126-34 (Feb 1997) ISSN: 0041-1132 [Print] United States
• PMID: 9051085 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Topics

• Adenocarcinoma (surgery)
• Colorectal Neoplasms (surgery)
• Erythrocyte Transfusion (adverse effects)
• Humans
• Incidence
• Prospective Studies
• Risk Factors
• Surgical Wound Infection (epidemiology)