Blood transfusion and postoperative plasma cytokine antagonist levels in colorectal cancer patients

Background/Aims: Postoperative cytokine antagonist response affects various factors. However, excessive stress responses are deleterious as increased plasma concentration of cytokine antagonists may induce an impaired immune system. Methodology: We determined plasma levels of cortisol, IL-1ra, and sTNF-R55 in 20 patients who had undergone resection of colorectal carcinoma. Ten patients had a blood transfusion during the operation (invasive group), but 10 patients had received no blood transfusion (less invasive group). Plasma levels of cytokine antagonists were determined before operation (POD 0) and POD-1, -2 and -7. Results: Postoperative plasma cortisol and sTNF-R55 levels were significantly elevated on POD-1 in the invasive group. Plasma IL-1ra levels were significantly increased on POD-1 in both the invasive and less invasive groups. Conclusions: The present study demonstrated that perioperative allogeneic blood transfusion can induce an excessive production of cortisol and sTNF-R55, and might be deleterious.