Transfusion of recombinant human erythropoietin-induced autologous blood and peri-operative changes in production of interleukin-2 in esophageal surgery

Abstract

Surgical stress-induced and allogeneic blood transfusion-induced immunosuppression may promote the rapid regrowth of residual minimum cancer and may accelerate metastasis to distant sites; it is important to develop countermeasures to protect against such post-operative immunosuppression. The effects of recombinant human erythropoietin (rH-EPO)-induced autologous blood donation and transfusion were examined in 14 patients with esophageal cancer, and the peri-operative changes in production of interleukin-2 (IL-2) were analyzed and compared to those of 11 control patients. Pre-operative blood was donated by all 14 rH-EPO-treared patients; the mean volume of blood donated was 824 ml. Allogeneic blood transfusion was performed in only 2 of the 14 patients, whereas it was necessary in 8 of 11 patients in the control group. The administration of rH-EPO resulted in a pre-operative trend towards increased production of IL-2 and the rapid recovery from impaired post-operative production of this cytokine. Our results indicate that preoperative administration of rH-EPO contributes both to the avoidance of allogeneic blood transfusion and to rapid recovery from post-operative impaired production of IL-2 after esophageal surgery.