title: Prevention of donor-specific T-cell unresponsiveness after buffy-coat-depleted blood transfusion.
abstract: The immunosuppressive effect of blood transfusions has been demonstrated in several clinical studies. The effect is probably mediated by HLA-class-II-bearing donor leucocytes, because results from laboratory tests show specific down-regulation of the recipient's T-Cell response after administration of blood from donors sharing one HLA haplotype with the recipient. In the present study we evaluated the immunosuppressive potential of buffy-coat-depleted red cell transfusions in patients waiting for renal transplantation, by measuring the frequency of cytotoxic precursor T cells before and after transfusion. The buffy coat was removed from whole blood by the Optipress system and resulted in > 97% depletion of lymphocytes and monocytes. A single transfusion of HLA-haplotype-matched buffy-coat-depleted red cells induced donor-specific down-regulation of T-cell responses in only two of 14 patients. Since HLA-class-II-bearing cells are also involved in the induction of anti-HLA antibodies, we evaluated retrospectively the incident of HLA alloimmunization after a single transfusion of buffy-coat-depleted red cells. No anti-HLA antibodies were found in 140 patients at risk for primary immunization. We conclude that the poor immunological responses found after a single transfusion of HLA-haplotype-matched buffy-coat-depleted red cells is due to the small number of residual HLA-class-II-bearing donor cells. This blood component should not be used for induction of immunosuppression.
authors.affiliation: Department of Haematology, University Hospital Utrecht, The Netherlands.
authors.forename: H C
authors.initials: HC
authors.lastname: van Prooijen
authors.forename: M I
authors.initials: MI
authors.lastname: Aarts-Riemens
authors.forename: W R
authors.initials: WR
authors.lastname: van Oostendorp
authors.forename: R J
authors.initials: RJ
authors.lastname: Hené
authors.forename: F H
authors.initials: FH
authors.lastname: Gmelig-Meyling
authors.forename: R A
authors.initials: RA
authors.lastname: de Weger
mesh_terms: D002469:Cell Separation; D017707:Erythrocyte Transfusion; D005260:Female; D005500:Follow-Up Studies; D006681:HLA-D Antigens / Q000276:immunology*; D006801:Humans; D007108:Immune Tolerance; D007958:Leukocyte Count; D007962:Leukocytes / Q000276:immunology; D008297:Male; D012189:Retrospective Studies; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology*
chemical_list: D006681:HLA-D Antigens