Transfusion‐associated microchimerism

Abstract

Blood transfusion is a newly recognized cause of microchimerism, the stable persistence of a minor population of allogeneic cells. Relatively recent advances in polymerase chain reaction technology have spawned new information about the frequency and aetiology of transfusion-associated microchimerism (TA-MC). Although conceptually related to fetal-maternal microchimerism, TA-MC is a distinct and separate entity. Evidence of TA-MC has been strongest among patients with severe traumatic injuries who receive relatively fresh blood products shortly after an episode of massive haemorrhage. The presence of a focal deficit in the cellular immunologic repertoire prior to transfusion that happens to match a blood donor's human leucocyte antigen type also appears to be an important predisposing factor. TA-MC seems to be common (affecting approximately 10% of transfused injured patients), enduring (lasting years to decades) and pronounced (involving up to 5% of circulating leucocytes and multiple immunophenotypic lineages suggestive of haematopoietic engraftment). Further study of this topic may reveal important information regarding potential clinical consequences of TA-MC, as well as basic haematologic and immunologic processes.

A systems approach to the early recognition and rapid administration of best practice therapy in sepsis and septic shock

“…In the Rivers study, red cell transfusions were initiated if the mixed venous oxygen tension was less than 70% after respiratory, fluid and vasopressor support and if the hematocrit was less than 30%. This seems to contradict other studies that showed no difference in mortality when red cells were given to critically ill patients [47] or, in fact, made them worse [48,49] because of infection and lung injury. As red cell transfusion was part of a 'bundle' of interventions, it is hard to discern what role individual parts had in the reduction of mortality.…”

Sexual Dimorphism in Hematocrit Response Following Red Blood Cell Transfusion of Critically Ill Surgical Patients

“…Furthermore, we observed both decreased survival and more aggressive tumor behavior for male mice, as compared to female mice, inoculated with pancreatic cancer cells following transfusion of female blood [23, 24]. Such differences may involve alloimmunization [22, 25] or even microchimerism [26] of multiparous female donors.…”

Passenger lymphocyte syndrome in ABO and Rhesus D minor mismatched liver and kidney transplantation: A prospective analysis

“…HLA sharing promotes lymphocyte engraftment in transfusion associated GVHD and microchimerism [32,33], nonetheless, it may not be necessary to facilitate PLS in RT patients. Kidney donor-recipient pairs were HLA mismatched and PLS occurred in 2 patients despite the presence of HLA disparity between donors and recipients.…”