[Effect of perioperative allogenic blood transfusion on prognosis of colorectal cancer].

In 1973 the observation was published that in patients who had received non specific blood transfusions before kidney transplantation graft survival was improved. An immunosuppressive effect of blood transfusion was suggested. Indeed, modulation on the cellular and humoral immunologic system has been demonstrated during the last decade. But this immunomodulation effect might worsen the prognosis after cancer surgery. Whereas in several experimental studies in animals the negative influence was confirmed, clinical investigations on the other hand are contradictive. In our retrospective study we analysed the follow-up of 273 patients (158 men, 115 women; average age 66 years) on which we had performed a curative resection of their colorectal carcinoma. 182 patients had received nonspecific random blood transfusions. The survival rate for patients with blood transfusions was significantly worse in comparison to the non-transfused group (43% versus 73%, respectively). Even when we subdivided our patients into tumor stage, differentiation and localisation, the negative influence of transfused blood was confirmed. We conclude that beside the risk of transmitting hepatitis or HIV the immunosuppressive effect is a strong argument to restrict the indication for blood transfusion.