HOST IMMUNOSUPPRESSION AFTER BLOOD TRANSFUSION AT THE OPERATION FOR GASTRIC CANCER AND AN ATTEMPT OF AUTOGENOUS BLOOD TRANSFUSION

Abstract

The author measured changes in subsets of peripheral lymphocytes in patients with gastric cancer to observehow the postoperative host immunity is influenced by the transfusion. In the cases without blood transfusion, the CD11(+)CD8(+) cell ratio began to increase at the early time of operation, while the CD4(+)2H4(+) cell ratio decreased. After that, CD11(+)CD8(+) cell ratio returned to preoperative number. CD4(+)2H4(-) cell ratio decreased at the operation and prolonged for a certain period according to the degree of advancement of the disease and operative prceedure. Change of host immunity by blood transfusion performed in addition to surgery was then investigated in 11 stage I+II patients undergoing subtotal resection. Compared with the non-transfusion group, the CD4(+)2H4(-) cell ratio more decreased and the CD11(+)CD8(+) bright cell ratio more increased in the transfusion group, revealing prolonged immunosuppression in the transfusion group. On the other hand, in 17 patients receiving autogenous blood transfusion, CD11(+)CD8(+) bright cell ratio rather suppressed than in the blood transfusion group, and the CD4(+)2H4(-) cell ratio more increased. Although blood transfusion was found to lead to immunosuppressive responce in this study, the use of autogenous blood transfusion eliminated such response.