Background and objectives: Immunosuppression associated with blood
transfusion may influence postoperative infection rates. It may also affect the
prognosis of patients treated surgically for colorectal cancer. To control this effect,
study protocols have applied autologous blood donation programs, which
are thought to be immunologically neutral. However, evidence has emerged that
blood donation itself might have suppressive effects on natural killer (NK) cell
activities. At present, there are no data available on the effects of autologous
blood transfusion on NK or lymphokine-activated killer (LAK) cells. This might
be of interest as LAK cells may be active in tumor control. Materials and methods:
26 patients who underwent surgical resection for colorectal cancer, were
assigned at random into two groups: (1) autologous blood donation and transfusion,
or (2) allogeneic blood transfusion. NK and LAK activities were determined
before blood donation, at surgery, and on the 3rd and 8th postoperative
day. Results: Blood donation induced a small decrease in NK and LAK activities.
The postoperative courses of the two groups differed. In the allogeneic
group, NK activity (-50%, p = 0.018) and LAK activity decreased (-60.7%,
p = 0.043), whereas in the autologous group the decline in LAK was less pronounced
(-33.7%, p = 0.091), and their NK activity even increased (+17.4%,
p = 0.315). NK activity was modulated differently in the two study groups
(0.0036). Differences in LAK activities were found between the 3rd and 8th day
postoperatively (p = 0.354). Conclusions: In patients receiving autologous
blood transfusion, postoperative suppressed NK and LAK activities were modulated.
This implies that autologous blood transfusion is not immunologically
neutral, but has an intrinsic immunomodulatory potential.