Effects Of Autotransfusion And Allotransfusion On Perioperative Immune Inflammatory Response In Patients With Liver Cancer

Objective: To investigate the effect of autotransfusion and allotransfusion on the immune function of liver cancer patients in perioperative period.Methods: according to patients' condition and willingness to adopt different ways of transfusion 60 patients with ASA classification ?-? liver cancer(ages 18-65 years)to open hepatic partial resection of liver cancer patients were randomly divided into 3 groups,selection of 20 cases of patients who had only for autologous blood transfusion patients(group M)and not to be blood transfusion 20 cases(group N),20 patients with intraoperative only input of allogeneic blood(group P).Group M is the acute isovolumetric hemodilution autotransfusion group,the anesthesia induction after intubation,according to the estimated blood loss or greater in 400 ml,from the radial artery bleeding,amount of bleeding is generally is 7 ml / ?,bright set amount does not exceed10% of the total capacity of the whole blood,intravenous input the same amount of hydroxyethyl starch at the same time.At the time of intraoperative bleeding,the patient is lost.Group P was the blood transfusion group of leukocyte allogeneic erythrocyte(after the transfusions of leukocyte allogeneic erythrocytetransfusion and the patient's cross matching,when the patient's hemoglobin was less than 70g/L or Hb was less than 80 g /L during the intraoperative bleeding,but further blood loss to the patient was still considered).Preoperative patient's hemoglobin is greater than 110 g/L,red blood cell volume is greater than 0.33,there is no virus and/or bacterial infection of the patients,no blood coagulation dysfunction,abnormal platelet count,no serious heart,lung,liver,kidney failure,no endocrine or autoimmune disease,not received radiotherapy,chemotherapy,or hormone therapy,did not receive drugs to strengthen the immune function.Venous blood was extracted at 3 time points before surgery,1 day after surgery and 5 days after surgery.Cellular immunity and humoral immunity were detected by flow cytometry after heparin anticoagulation.Inflammatory cytokines il-6 and il-8 were detected by ELISA.SPSS 17.0 statistical software was used for analysis.The measurement data were expressed as mean standard deviation(s),univariate anova was used for comparison between groups,chi-square test was used for comparison of counting data,and P <0.05 was considered statistically significantResults:On the first day after surgery,Th,Th/Ts,NK,IgG,IgA,IgM in the three groups all decreased,Ts,IL-6,and IL-8 all increased,but there was no significant difference in the indicators between the autotransfusion group and the non-transfusion group(P >0.05),while there was a significant difference in the indicators between the allogeneic transfusion group and the preoperative group(P <0.05).On the fifth day after surgery,the patients in the autotransfusion group and the non-transfusion group recovered faster and returned to the preoperative level,while the allogeneic blood transfusion was lower than that before surgery(P <0.05).Conclusion:Postoperative immunosuppression was suggested in patients with hepatectomy and allogeneic blood transfusion.Autologous blood transfusion can alleviate the immunosuppression in patients with hepatectomy,which may be related to the reduction of allogeneic blood transfusion and the preservation of the immune components of autologous blood.