Immunological aspects of blood transfusions

被引:99
作者
Brand, A [1 ]
机构
[1] Leiden Univ, Sanquin Fdn, Med Ctr, Dept Immunohaematol & Blood Transfus, NL-2300 RA Leiden, Netherlands
关键词
blood transfusion; transfusion reactions; transfusion-induced immunesupressor;
D O I
10.1016/S0966-3274(02)00064-3
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Almost all identified acute and/or severe immunological reactions towards blood transfusions, reported by surveillance systems such as SHOT (Severe Hazards of Transfusion) in the UK are mediated by allo-antibodies. In contrast, the clinical effects of transfusion-induced cellular immunity are virtually unknown. Although alterations in lymphocyte responses and natural killer cell functions after blood transfusion has been reported in many publications, the relevance of these in vitro assays for in vivo immunity are lacking. Even for clinically obvious immunomodulatory effect of blood transfusions, such as the mitigation of renal graft rejection, no uniform in vitro explanation has been identified. In the laboratory animal it has been shown that when two antigenic stimuli are given simultaneously, the response to one of these antigens is often decreased. Blood transfusions introduce a multitude of foreign antigens. Indeed, immunostimulation and suppression by blood transfusions have both been found. Systematic studies on immunological side-effects of blood transfusions are hardly available. Since the UK and France introduced a transfusion vigilance system, severe immunological side-effects such as haemolytic reactions, TRALI (acute lung injury), PTP (post-transfusion purpura) and graft vs. host disease are registrated in these countries and their incidence can be estimated based on the national number of transfusions. However, every blood transfusion interferes with the immune system of the recipient. The available evidence of harm from immune responses not leading to severe transfusion reactions will be discussed. (C) 2002 Elsevier Science B.V. All lights reserved.
引用
收藏
页码:183 / 190
页数:8
相关论文
共 39 条
[1]   Massive immune haemolysis after allogeneic peripheral blood stem cell transplantation with minor ABO incompatibility [J].
Bolan, CD ;
Childs, RW ;
Procter, JL ;
Barrett, AJ ;
Leitman, SF .
BRITISH JOURNAL OF HAEMATOLOGY, 2001, 112 (03) :787-795
[2]  
BRAND A, 1999, IMMUNOMODULATORY EFF, V9, P145
[3]   BLOOD-TRANSFUSIONS AND PROGNOSIS IN COLORECTAL-CANCER [J].
BUSCH, ORC ;
HOP, WCJ ;
VANPAPENDRECHT, MAWH ;
MARQUET, RL ;
JEEKEL, J .
NEW ENGLAND JOURNAL OF MEDICINE, 1993, 328 (19) :1372-1376
[4]  
CLAAS FHJ, 1981, EXP HEMATOL, V9, P84
[5]   Leukocyte-reduced red blood cell transfusions in patients with anemia and human immunodeficiency virus infection - The viral activation transfusion study: A randomized controlled trial [J].
Collier, AC ;
Kalish, LA ;
Busch, MP ;
Gernsheimer, T ;
Assmann, SF ;
Lane, TA ;
Asmuth, DM ;
Lederman, MM ;
Murphy, EL ;
Kumar, P ;
Kelley, M ;
Flanigan, TP ;
McMahon, DK ;
Sacks, HS ;
Kennedy, MS ;
Holland, PV .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 285 (12) :1592-1601
[6]   CYTOKINE PRODUCTION IN IGG-MEDIATED RED-CELL INCOMPATIBILITY [J].
DAVENPORT, RD ;
BURDICK, M ;
MOORE, SA ;
KUNKEL, SL .
TRANSFUSION, 1993, 33 (01) :19-24
[7]   MONONUCLEAR CELL MICROCHIMERISM AND THE IMMUNOMODULATORY EFFECT OF TRANSFUSION [J].
DZIK, WH .
TRANSFUSION, 1994, 34 (11) :1007-1012
[8]  
EERNISSE JG, 1981, EXP HEMATOL, V9, P77
[9]  
HEAL JM, 1980, BRIT J HAEMATOL, V1, P83
[10]   A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care [J].
Hébert, PC ;
Wells, G ;
Blajchman, MA ;
Marshall, J ;
Martin, C ;
Pagliarello, G ;
Tweeddale, M ;
Schweitzer, I ;
Yetisir, E .
NEW ENGLAND JOURNAL OF MEDICINE, 1999, 340 (06) :409-417