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Erythrocyte transfusion causes immunosuppression after total hip replacement
S J Kendall1, J Weir, R Aspinall
1Royal Surrey County Hospital, Guildford, United Kingdom.
Clinical Orthopaedics and Related Research
|December 29, 2000
Summary
Homologous erythrocyte transfusions after hip replacement surgery can suppress cell-mediated immunity. This immune suppression may increase the risk of postoperative infections, including prosthesis infection.
Area of Science:
- Immunology
- Transfusion Medicine
- Orthopedic Surgery
Background:
- Postoperative immunosuppression is a concern following major surgery.
- The role of homologous erythrocyte transfusion in modulating the immune response requires further investigation.
Purpose of the Study:
- To investigate the impact of homologous erythrocyte transfusion on cell-mediated immunity in patients undergoing total hip replacement.
- To assess the potential link between transfusion and postoperative immune dysfunction.
Main Methods:
- Prospective study of 34 patients undergoing total hip replacement.
- Comparison of immune cell subsets (CD3+, CD3+4+, CD3+4-8-, CD19+) and lymphocyte function (Candida recall test) between transfused and untransfused groups.
- Analysis of immune parameters at postoperative Days 2 and 7.
Main Results:
- Transfused patients showed reduced CD3+ and CD3+4+ cell numbers at Day 2.
- Uninfused patients exhibited increased lymphocyte counts by Day 7.
- Impaired Candida recall response observed in transfused patients at Day 7, indicating compromised T-cell memory function.
Conclusions:
- Homologous erythrocyte transfusion is associated with cell-mediated immune suppression after hip replacement.
- Perioperative transfusion may elevate the risk of infectious complications, such as prosthesis infection.