Transfusion-associated microchimerism.
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.
Utter
G H
GH
Department of Surgery, UC, Davis Medical Center, Sacramento, CA 95817, USA. garth.utter@ucdmc.ucdavis.edu
Reed
W F
WF
Lee
T-H
TH
Busch
M P
MP
D046528:Chimerism; D006801:Humans; D017708:Leukocyte Transfusion / Q000009:adverse effects*; D016133:Polymerase Chain Reaction