Transfusion-induced immunosuppression: Abrogation by leucodepletion

B LOOD TRANSFUSION causes a nonspecific downregulation of immune function and, although the mechanism of this is as yet unclear, it is likely that the HLA material present on the donor leucocytes is invo1ved.l This transfusion effect may have implications in the field of cancer surgery as a decrease in the host’s immune function at the time of resection of a tumour, when malignant cells are being shed into the circulation, may increase the likelihood of local and metastatic recurrence. A variety of studies have shown perioperative blood transfusion to be a poor prognostic indicator for cancer patients undergoing surgery, while others refute this.2x3 This study was designed to study the hypothesis that transfusion of leucodepleted blood at the time of major surgery results in less immunosuppression than standard blood.4