Retrospective and Prospective Studies on the Effect of Blood Transfusions in Renal Transplantation in the Netherlands

Endogenous dendritic cells mediate the effects of intravenously injected therapeutic immunosuppressive dendritic cells in transplantation

“…[1][2][3][4][5][6][7] The beneficial effect of DST depends on the presence of leukocytes and donor antigen (Ag), [8][9][10] the load and immunogenicity of the allo-Ag transferred, 4,9 and the time of administration before transplantation. 6,10 Early studies suggested that DSTmediated immunosuppression requires that T cells recognize directly donor-Ag expressed by the transfused leukocytes.…”

Increased Bacterial Translocation and Impaired Immune Response after Transfusion of Allogeneic Leukocytes

“…Production, in vitro, of PGE2 by splenic macrophages with and without the addition of LPS in the cellular culture. fraction [29,30] and plasma [31,32] has been demon strated to alter the immune response in both experimental and clinical protocols. The results of the present investiga tion showed that animals receiving transfusion of allo geneic leukocytes had a statistical significant increase in bacterial translocation (measured by radionuclide count of the 14C E. coli) in all the tested tissues compared to mice transfused with RBC.…”

Blood Transfusion as Regulator of the Immune Response

“…Notwithstanding the progress made in immunosuppressive drugs and histocompatibility matching since then, the effect can still be demonstrated [54]. Important observations concerning the underlying mechanism were made by Persijn et al [6] who showed that a single transfusion could suffice as long as it was not leukocyte-depleted by filtration, and by Lagaaij et al [55] who showed a crucial role for HLA-DR matching of the blood transfusion with the recipient. Over the years, mechanisms like donor selection, anergy and apoptosis have been suggested for this 'blood transfusion effect': -Donor selection: Selection of a cross-match-negative donor in poly-transfused patients will preferentially select donors against whom a patient cannot easily respond [56].…”

“…It therefore came as a surprise when Opelz et al [5] reported that transfused patients had a superior graft survival compared to non-transfused patients. Reducing the leukocytes within the transfused blood by passing the blood over a filter reduced the incidence of alloantibody formation, but also annihilated the positive effect on graft survival [6]. Leukocytes within a blood transfusion therefore seem not only able to activate the immune system, as with alloimmunization, but also to suppress the immune system, as seen with prolonged graft survival.…”