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. 1992 Mar;215(3):276–281. doi: 10.1097/00000658-199203000-00013

Blood transfusion impairs the healing of experimental intestinal anastomoses.

T Tadros 1, T Wobbes 1, T Hendriks 1
PMCID: PMC1242433  PMID: 1543401

Abstract

Blood transfusions are reported to impair the cell-mediated immune response. Because both T lymphocyte and macrophage function are important for wound repair, the authors investigated the effect of blood transfusions on anastomotic repair. Lewis rats underwent resection of both ileum and colon, followed by the construction of either an everted or an inverted end-to-end anastomosis. Immediately after operation, they received either 3 mL saline intravenously, or 3 mL heparinized blood from Lewis or Brown Norway donors. The animals were killed 3 or 7 days after operation, and anastomotic strength was assessed by measuring the bursting pressure. Anastomotic abscesses and generalized peritonitis were not found in the control group. Blood transfusions, particularly allogeneic, significantly increased the incidence of these septic complications. Three days after operation, anastomotic strength was significantly reduced in both Lewis and Brown Norway transfused groups. For instance, average bursting pressures (+/- standard deviation [SD]) of inverted ileal anastomoses were 79 +/- 13 mmHg in the control group and 46 +/- 14 and 21 +/- 12 mmHg in the Lewis and Brown Norway transfused groups, respectively. Seven days after operation, the rupture site was found significantly more often within the anastomotic line in the animals that had received blood transfusions. The authors conclude that blood transfusions impair the healing of experimental intestinal anastomoses and increase susceptibility to intra-abdominal sepsis.

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Selected References

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  1. Barbul A., Breslin R. J., Woodyard J. P., Wasserkrug H. L., Efron G. The effect of in vivo T helper and T suppressor lymphocyte depletion on wound healing. Ann Surg. 1989 Apr;209(4):479–483. doi: 10.1097/00000658-198904000-00015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Barbul A., Knud-Hansen J., Wasserkrug H. L., Efron G. Interleukin 2 enhances wound healing in rats. J Surg Res. 1986 Apr;40(4):315–319. doi: 10.1016/0022-4804(86)90193-9. [DOI] [PubMed] [Google Scholar]
  3. Fielding L. P., Stewart-Brown S., Blesovsky L., Kearney G. Anastomotic integrity after operations for large-bowel cancer: a multicentre study. Br Med J. 1980 Aug 9;281(6237):411–414. doi: 10.1136/bmj.281.6237.411. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Fishel R. S., Barbul A., Beschorner W. E., Wasserkrug H. L., Efron G. Lymphocyte participation in wound healing. Morphologic assessment using monoclonal antibodies. Ann Surg. 1987 Jul;206(1):25–29. doi: 10.1097/00000658-198707000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Foster R. S., Jr, Costanza M. C., Foster J. C., Wanner M. C., Foster C. B. Adverse relationship between blood transfusions and survival after colectomy for colon cancer. Cancer. 1985 Mar 15;55(6):1195–1201. doi: 10.1002/1097-0142(19850315)55:6<1195::aid-cncr2820550610>3.0.co;2-h. [DOI] [PubMed] [Google Scholar]
  6. Francis D. M., Shenton B. K. Blood transfusion and tumour growth: evidence from laboratory animals. Lancet. 1981 Oct 17;2(8251):871–871. doi: 10.1016/s0140-6736(81)91133-8. [DOI] [PubMed] [Google Scholar]
  7. Gill T. J., 3rd, Kunz H. W., Misra D. N., Hassett A. L. The major histocompatibility complex of the rat. Transplantation. 1987 Jun;43(6):773–785. [PubMed] [Google Scholar]
  8. Hendriks T., Mastboom W. J. Healing of experimental intestinal anastomoses. Parameters for repair. Dis Colon Rectum. 1990 Oct;33(10):891–901. doi: 10.1007/BF02051930. [DOI] [PubMed] [Google Scholar]
  9. Hesp F. L., Hendriks T., Lubbers E. J., de Boer H. H. Wound healing in the intestinal wall. Effects of infection on experimental ileal and colonic anastomoses. Dis Colon Rectum. 1984 Jul;27(7):462–467. doi: 10.1007/BF02555541. [DOI] [PubMed] [Google Scholar]
  10. Hesp F. L., Hendriks T., Lubbers E. J., deBoer H. H. Wound healing in the intestinal wall. A comparison between experimental ileal and colonic anastomoses. Dis Colon Rectum. 1984 Feb;27(2):99–104. doi: 10.1007/BF02553985. [DOI] [PubMed] [Google Scholar]
  11. Hyman N. H., Foster R. S., Jr, DeMeules J. E., Costanza M. C. Blood transfusions and survival after lung cancer resection. Am J Surg. 1985 Apr;149(4):502–507. doi: 10.1016/s0002-9610(85)80047-7. [DOI] [PubMed] [Google Scholar]
  12. Kaplan J., Sarnaik S., Gitlin J., Lusher J. Diminished helper/suppressor lymphocyte ratios and natural killer activity in recipients of repeated blood transfusions. Blood. 1984 Jul;64(1):308–310. [PubMed] [Google Scholar]
  13. Opelz G., Sengar D. P., Mickey M. R., Terasaki P. I. Effect of blood transfusions on subsequent kidney transplants. Transplant Proc. 1973 Mar;5(1):253–259. [PubMed] [Google Scholar]
  14. Peterson J. M., Barbul A., Breslin R. J., Wasserkrug H. L., Efron G. Significance of T-lymphocytes in wound healing. Surgery. 1987 Aug;102(2):300–305. [PubMed] [Google Scholar]
  15. Schot J. D., Schuurman R. K. Blood transfusion suppresses cutaneous cell-mediated immunity. Clin Exp Immunol. 1986 Aug;65(2):336–344. [PMC free article] [PubMed] [Google Scholar]
  16. Schrock T. R., Deveney C. W., Dunphy J. E. Factor contributing to leakage of colonic anastomoses. Ann Surg. 1973 May;177(5):513–518. doi: 10.1097/00000658-197305000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Stephan R. N., Kisala J. M., Dean R. E., Geha A. S., Chaudry I. H. Effect of blood transfusion on antigen presentation function and on interleukin 2 generation. Arch Surg. 1988 Feb;123(2):235–240. doi: 10.1001/archsurg.1988.01400260123016. [DOI] [PubMed] [Google Scholar]
  18. Tartter P. I., Heimann T. M., Aufses A. H., Jr Blood transfusion, skin test reactivity, and lymphocytes in inflammatory bowel disease. Am J Surg. 1986 Mar;151(3):358–361. doi: 10.1016/0002-9610(86)90467-8. [DOI] [PubMed] [Google Scholar]
  19. Tartter P. I., Quintero S., Barron D. M. Perioperative blood transfusion associated with infectious complications after colorectal cancer operations. Am J Surg. 1986 Nov;152(5):479–482. doi: 10.1016/0002-9610(86)90207-2. [DOI] [PubMed] [Google Scholar]
  20. Waymack J. P., Balakrishnan K., McNeal N., Gonce S., Miskell P., Warden G. D., Alexander J. W. Effect of blood transfusions on macrophage-lymphocyte interaction in an animal model. Ann Surg. 1986 Dec;204(6):681–685. doi: 10.1097/00000658-198612000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Waymack J. P., Gallon L., Barcelli U., Alexander J. W. Effect of blood transfusions on macrophage function in a burned animal model. Curr Surg. 1986 Jul-Aug;43(4):305–307. [PubMed] [Google Scholar]
  22. Waymack J. P., Gallon L., Barcelli U., Trocki O., Alexander J. W. Effect of blood transfusions on immune function. III. Alterations in macrophage arachidonic acid metabolism. Arch Surg. 1987 Jan;122(1):56–60. doi: 10.1001/archsurg.1987.01400130062009. [DOI] [PubMed] [Google Scholar]
  23. Waymack J. P., Rapien J., Garnett D., Tweddell J. S., Alexander J. W. Effect of transfusion on immune function in a traumatized animal model. Arch Surg. 1986 Jan;121(1):50–55. doi: 10.1001/archsurg.1986.01400010056007. [DOI] [PubMed] [Google Scholar]
  24. Waymack J. P., Warden G. D., Alexander J. W., Miskell P., Gonce S. Effect of blood transfusion and anesthesia on resistance to bacterial peritonitis. J Surg Res. 1987 May;42(5):528–535. doi: 10.1016/0022-4804(87)90028-x. [DOI] [PubMed] [Google Scholar]
  25. Waymack J. P., Yurt R. W. The effect of blood transfusions on immune function. V. The effect on the inflammatory response to bacterial infections. J Surg Res. 1990 Feb;48(2):147–153. doi: 10.1016/0022-4804(90)90207-i. [DOI] [PubMed] [Google Scholar]
  26. Wobbes T., Bemelmans B. L., Kuypers J. H., Beerthuizen G. I., Theeuwes A. G. Risk of postoperative septic complications after abdominal surgical treatment in relation to perioperative blood transfusion. Surg Gynecol Obstet. 1990 Jul;171(1):59–62. [PubMed] [Google Scholar]
  27. Wood M. L., Gottschalk R., Monaco A. P. Effect of blood transfusion on IL-2 production. Transplantation. 1988 May;45(5):930–935. doi: 10.1097/00007890-198805000-00018. [DOI] [PubMed] [Google Scholar]

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