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II. Effect on Mortality Rate Following Septic Challenge

J. Paul Waymack, MD; Edward Robb, MS; J. Wesley Alexander, MD, ScD

Arch Surg. 1987;122(8):935-939.

Abstract
• It is well established that transfusions given prior to transplantation diminish rejection, and recent reports suggest that transfused patients having surgery for cancer developed more metastases than those who did not receive transfusions. To our knowledge, however, there are no studies evaluating whether transfusions result in increased rates of infections. To investigate this, 295 Lewis rats were subjected to a 25% total body surface area burn and were given either 3 mL of Lewis blood, 3 mL of A'Solagoft Cancer Institute rat blood, or 9 mL of lactated Ringers' solution intravenously on day 1 before burn or on the day of burn. One additional group received 1-mL transfusions on days 9, 7, and 5 before burn. The burns were painted with 1x10⁸ Pseudomonas aeruginosa lot No. 1244 on postburn days 0,1, or 2. All rats were followed up for 28 days and survival and mean survival times were recorded. Transfusion of A'Solagoft Cancer Institute blood increased mortality unless given within 24 hours prior to Pseudomonas challenge, when it diminished mortality. Transfusion with syngeneic Lewis blood had no effect. We conclude that transfusions may adversely affect survival when given before bacterial challenge, possibly due to immunosuppression from exposure to non—self-histocompatibility antigens.

(Arch Surg 1987;122:935-939)

Author Affiliations
From the Department of Research, Shriners Burns Institute, Cincinnati Unit (Drs Waymack and Alexander and Mr Robb), and the Department of Surgery, University of Cincinnati (Drs Waymack and Alexander).

Footnotes
Accepted for publication May 29, 1986.

Reprint requests to Shriners Burns Institute, 202 Goodman St, Cincinnati, OH 45219 (Dr Waymack).

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