Salo M
Department of Anaesthesiology, University of Turku, Finland.
Acta Anaesthesiol Scand Suppl. 1988;89:26-34. doi: 10.1111/j.1399-6576.1988.tb02839.x.
The immunosuppressive effects of blood transfusion at surgical operations become manifest as enhanced graft survival, increased cancer recurrence and decreased patient survival, and increased susceptibility to postoperative infections. Blood transfusion in transplant recipients no longer offers this advantage when cyclosporine A is used. The deleterious effects of blood transfusion on the prognosis of some cancers found in the statistical analyses of retrospective studies are considered to be of increasing clinical importance. Therefore, unnecessary blood transfusions should be avoided and special attention directed to the use of autologous blood. Leucocyte-free red blood concentrates are the least immunosuppressive homologous blood preparations. Conventional red blood cell concentrates may also be used in cancer patients until ongoing prospective randomized studies confirm that there is a true association between the use of homologous blood and increased recurrence of cancer.
手术输血的免疫抑制作用表现为移植存活率提高、癌症复发增加、患者存活率降低以及术后感染易感性增加。当使用环孢素A时，移植受者输血不再具有此优势。回顾性研究的统计分析发现，输血对某些癌症预后的有害影响在临床上的重要性日益增加。因此，应避免不必要的输血，并特别关注自体血的使用。去白细胞红细胞浓缩物是免疫抑制作用最小的同源血液制品。在正在进行的前瞻性随机研究证实同源血的使用与癌症复发增加之间存在真正关联之前，传统红细胞浓缩物也可用于癌症患者。
