Prevention of blood-transfusion-induced impairment of anastomotic healing by leucocyte depletion in rats

Abstract

Objective: To find out what effect whole blood and leucocyte-depleted blood transfusions had on the healing process of intestinal anastomoses in rats. Design: Experimental study. Setting: Teaching hospital, Greece. Subjects: 100 Wistar rats in five groups of 20 each. Interventions: Small and large bowel anastomoses were made and the five groups were given normal saline, homologous whole blood, heterologous whole blood obtained from PVG rats, homologous leucocyte-depleted blood or heterologous leucocyte-depleted blood during the operation. Main outcome measures: Bursting pressures of anastomoses on the third and seventh postoperative days and infective complications. Results: The groups given whole blood transfusions had significantly more anastomotic abscesses than controls (p = 0.003 compared with heterologous, p = 0.05 compared with homologous for the small bowel, and p = 0.007 for the large bowel). The pressure measurements indicated a significant reduction in anastomotic strength in the same groups compared with the control group (p = 0.0001/p = 0.001 on the third postoperative day, and p = 0.00001/p = 0.0004 on the seventh postoperative day for small and large bowel, respectively). There was no reduction in anastomotic strength in the leucocyte-depleted blood groups. Conclusions: Transfusion of leucocyte- depleted blood does not seem to impair intestinal anastomotic healing and carries an acceptable incidence of postoperative complications.