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multiple donors. Three women had normal pregnancies and deliveries at term. Several groups have replicated this work with spouse leukocytes and successful deliveries result in more than 50% of the women treated. Crohn's Disease Crohn's disease is an inflammatory condition of the gastrointestinal tract which presents with diarrhea and crampy abdominal pain. Recurrence of disease following surgery is common -nearly half of the patients will develop symptoms of recurrence within ten years of surgical resection of all diseased bowel. Immune function is abnormal and patients are often treated with immunosuppressive steroids. Transfused patients have significantly decreased total lymphocyte and t-cell counts following surgery despite being clinically well. Increasing numbers of units of blood received are associated with progressively lower numbers of lymphocytes at follow-up. Several groups have studied the effect of blood transfusion on the outcome Crohn's disease because the immunosuppressive effects of transfusion might benefit patients in the same way steroids affect the course to the disease. Most of the studies observed that untransfused patients exhibited higher rates of recurrence than transfused patients (37-40). The studies suggest that transfusion may influence the course of diseases which are thought to have an immune or autoimmune basis and clinically respond to steroids. Crohn's disease patients with more severe disease, those with lower hemoglobins and serum albumins, undergoing resection of more bowel, should have higher recurrence rates. Yet, these patients when transfused have recurrence rates comparable to untransfused patients with higher hemoglobins and albumins and less bowel resected. Wound Healing It has recently been recognized that lymphocytes contribute to wound healing which is primarily mediated by macrophages. Lymphocytes secrete lymphokines which enhance fibroblast replication, migration and collagen synthesis. In vivo depletion of lymphocytes impairs skin wound healing. Since transfusions inhibit lymphocyte function, transfusion-induced inhibition of lymphocyte function should lead to impaired wound healing (41). Rats undergoing ileocolic resection with primary anastomosis and transfusion with saline, syngeneic or allogeneic blood were sacrificed three and seven days following surgery and the bursting pressure of the anastomosis measured. Bursting pressure was significantly lower following transfusion with syngeneic or allogeneic blood in comparison to saline. Hydroxyproline content of the anastomoses was reduced and anastomotic abscesses were common in the transfused animals. This study clearly implicates blood transfusion in impaired wound healing. D iabetes In man, insulin dependent diabetes mellitus is associated with decreases in both the number and functional activity of suppresser T lymphocytes. In the Bio-Breeding rat, diabetes develops when the animals develop pancreatic insulitis, suggesting a cell-mediated immune pathogenesis. Diabetes is prevented in these animals by treating them with immunosuppressive agents such as anti-lymphocyte serum, steroids, cyclosporin, irradiation, neonatal thymectomy, or blood transfusion (42).
DOI link for multiple donors. Three women had normal pregnancies and deliveries at term. Several groups have replicated this work with spouse leukocytes and successful deliveries result in more than 50% of the women treated. Crohn's Disease Crohn's disease is an inflammatory condition of the gastrointestinal tract which presents with diarrhea and crampy abdominal pain. Recurrence of disease following surgery is common -nearly half of the patients will develop symptoms of recurrence within ten years of surgical resection of all diseased bowel. Immune function is abnormal and patients are often treated with immunosuppressive steroids. Transfused patients have significantly decreased total lymphocyte and t-cell counts following surgery despite being clinically well. Increasing numbers of units of blood received are associated with progressively lower numbers of lymphocytes at follow-up. Several groups have studied the effect of blood transfusion on the outcome Crohn's disease because the immunosuppressive effects of transfusion might benefit patients in the same way steroids affect the course to the disease. Most of the studies observed that untransfused patients exhibited higher rates of recurrence than transfused patients (37-40). The studies suggest that transfusion may influence the course of diseases which are thought to have an immune or autoimmune basis and clinically respond to steroids. Crohn's disease patients with more severe disease, those with lower hemoglobins and serum albumins, undergoing resection of more bowel, should have higher recurrence rates. Yet, these patients when transfused have recurrence rates comparable to untransfused patients with higher hemoglobins and albumins and less bowel resected. Wound Healing It has recently been recognized that lymphocytes contribute to wound healing which is primarily mediated by macrophages. Lymphocytes secrete lymphokines which enhance fibroblast replication, migration and collagen synthesis. In vivo depletion of lymphocytes impairs skin wound healing. Since transfusions inhibit lymphocyte function, transfusion-induced inhibition of lymphocyte function should lead to impaired wound healing (41). Rats undergoing ileocolic resection with primary anastomosis and transfusion with saline, syngeneic or allogeneic blood were sacrificed three and seven days following surgery and the bursting pressure of the anastomosis measured. Bursting pressure was significantly lower following transfusion with syngeneic or allogeneic blood in comparison to saline. Hydroxyproline content of the anastomoses was reduced and anastomotic abscesses were common in the transfused animals. This study clearly implicates blood transfusion in impaired wound healing. D iabetes In man, insulin dependent diabetes mellitus is associated with decreases in both the number and functional activity of suppresser T lymphocytes. In the Bio-Breeding rat, diabetes develops when the animals develop pancreatic insulitis, suggesting a cell-mediated immune pathogenesis. Diabetes is prevented in these animals by treating them with immunosuppressive agents such as anti-lymphocyte serum, steroids, cyclosporin, irradiation, neonatal thymectomy, or blood transfusion (42).
multiple donors. Three women had normal pregnancies and deliveries at term. Several groups have replicated this work with spouse leukocytes and successful deliveries result in more than 50% of the women treated. Crohn's Disease Crohn's disease is an inflammatory condition of the gastrointestinal tract which presents with diarrhea and crampy abdominal pain. Recurrence of disease following surgery is common -nearly half of the patients will develop symptoms of recurrence within ten years of surgical resection of all diseased bowel. Immune function is abnormal and patients are often treated with immunosuppressive steroids. Transfused patients have significantly decreased total lymphocyte and t-cell counts following surgery despite being clinically well. Increasing numbers of units of blood received are associated with progressively lower numbers of lymphocytes at follow-up. Several groups have studied the effect of blood transfusion on the outcome Crohn's disease because the immunosuppressive effects of transfusion might benefit patients in the same way steroids affect the course to the disease. Most of the studies observed that untransfused patients exhibited higher rates of recurrence than transfused patients (37-40). The studies suggest that transfusion may influence the course of diseases which are thought to have an immune or autoimmune basis and clinically respond to steroids. Crohn's disease patients with more severe disease, those with lower hemoglobins and serum albumins, undergoing resection of more bowel, should have higher recurrence rates. Yet, these patients when transfused have recurrence rates comparable to untransfused patients with higher hemoglobins and albumins and less bowel resected. Wound Healing It has recently been recognized that lymphocytes contribute to wound healing which is primarily mediated by macrophages. Lymphocytes secrete lymphokines which enhance fibroblast replication, migration and collagen synthesis. In vivo depletion of lymphocytes impairs skin wound healing. Since transfusions inhibit lymphocyte function, transfusion-induced inhibition of lymphocyte function should lead to impaired wound healing (41). Rats undergoing ileocolic resection with primary anastomosis and transfusion with saline, syngeneic or allogeneic blood were sacrificed three and seven days following surgery and the bursting pressure of the anastomosis measured. Bursting pressure was significantly lower following transfusion with syngeneic or allogeneic blood in comparison to saline. Hydroxyproline content of the anastomoses was reduced and anastomotic abscesses were common in the transfused animals. This study clearly implicates blood transfusion in impaired wound healing. D iabetes In man, insulin dependent diabetes mellitus is associated with decreases in both the number and functional activity of suppresser T lymphocytes. In the Bio-Breeding rat, diabetes develops when the animals develop pancreatic insulitis, suggesting a cell-mediated immune pathogenesis. Diabetes is prevented in these animals by treating them with immunosuppressive agents such as anti-lymphocyte serum, steroids, cyclosporin, irradiation, neonatal thymectomy, or blood transfusion (42).
ABSTRACT