Original CommunicationsUsefulness of autologous blood transfusion for avoiding allogenic transfusion and infectious complications after esophageal cancer resection*
Section snippets
Patient selection
We retrospectively reviewed the medical records of 508 patients who underwent esophagectomy for esophageal cancer at the Department of Surgery of Toranomon Hospital between January 1984 and December 1997. All patients were evaluated before treatment by means of a history and a physical examination, as well as chest roentgenography, endoscopy, barium esophagography, computed tomography, and ultrasonography. All had biopsy-proven squamous cell carcinoma of the esophagus. Eighty-eight patients who
Results
A total of 105 patients were enrolled in the ABT group. Five patients (4.8%) were excluded because only 400 mL of autologous blood was collected. There were no side effects of phlebotomy with the administration of rHuEPO and ferric pyrophosphate. Although operative blood loss was similar in the two groups, significantly fewer patients from the ABT group required allogenic blood transfusion compared with those from the control group. Only three patients (3%) from the ABT group received allogenic
Discussion
Transfusion-mediated immunosuppression in cancer-bearing hosts was initially studied through animal experiments rather than clinically. Francis et al12 reported that allogenic transfusion was followed by depression of in vitro lymphocyte reactivity to antigenic and mitogenic stimuli as well as an increase of lymphocyte suppressive activity in the plasma. Clarke et al13 suggested that the growth rate of the primary tumor was not altered by transfusing animals with allogenic blood, but
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Reprint requests: Yoshihiro Kinoshita, MD, Department of Surgery, Toranomon Hospital, 2-2-2, Minato-ku, Toranomon, Tokyo, 105-8470, Japan.