| Autor: |
Roets M; Department of Anaesthesia, the Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.; Faculty of Medicine, the University of Queensland, Queensland, Australia., Sturgess DJ; Faculty of Medicine, the University of Queensland, Queensland, Australia.; Department of Anaesthesia, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia., Obeysekera MP; Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia., Tran TV; Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia., Wyssusek KH; Department of Anaesthesia, the Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.; Faculty of Medicine, the University of Queensland, Queensland, Australia., Punnasseril JEJ; Faculty of Medicine, the University of Queensland, Queensland, Australia., da Silva D; Department of Anaesthesia, the Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.; Faculty of Medicine, the University of Queensland, Queensland, Australia., van Zundert A; Department of Anaesthesia, the Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.; Faculty of Medicine, the University of Queensland, Queensland, Australia., Perros AJ; Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia., Tung JP; Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia., Flower RLP; Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia., Dean MM; Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia.; School of Health and Sport Sciences, University of the Sunshine Coast, Petrie, Queensland, Australia. |
| Abstrakt: |
Allogeneic blood transfusion (ABT) is associated with transfusion-related immune modulation (TRIM) and subsequent poorer patient outcomes including perioperative infection, multiple organ failure, and mortality. The precise mechanism(s) underlying TRIM remain largely unknown. During intraoperative cell salvage (ICS) a patient's own (autologous) blood is collected, anticoagulated, processed, and reinfused. One impediment to understanding the influence of the immune system on transfusion-related adverse outcomes has been the inability to characterize immune profile changes induced by blood transfusion, including ICS. Dendritic cells and monocytes play a central role in regulation of immune responses, and dysfunction may contribute to adverse outcomes. During a prospective observational study ( n = 19), an in vitro model was used to assess dendritic cell and monocyte immune responses and the overall immune response following ABT or ICS exposure. Exposure to both ABT and ICS suppressed dendritic cell and monocyte function. This suppression was, however, significantly less marked following ICS. ICS presented an improved immune competence. This assessment of immune competence through the study of intracellular cytokine production, co-stimulatory and adhesion molecules expressed on dendritic cells and monocytes, and modulation of the overall leukocyte response may predict a reduction of adverse outcomes ( i.e., infection) following ICS. |
