Increased recurrence rates in perioperatively transfused colorectal malignancy patients.

Blood transfusions have been shown to induce immunomodulative alterations in the transfusee such as changes in suppressor to helper T-cell ratio. They also have a beneficial antirejection effect in renal transplant recipients. To determine if blood transfusions play a role in tumor recurrence, the records of 177 transfused and 118 untransfused patients with Dukes stages B2, C1, or C2 operated on between June 1976 and July 1979 were examined. Ninety-five percent of untransfused patients were recurrence free at the end of 1 year compared to 86% of perioperatively transfused patients (P greater than .005), and this difference persisted for the 5 years of the study. Transfused patients in any of the pathological stages had lower recurrence-free rates in every postoperative year. Critical statistical analysis in this retrospective study indicates that the administration of blood is an important factor in the development of recurrence, and the increased incidence of recurrence is unrelated to the extent of operation or to the clinical need for transfusions before or during surgery.