title: Transfusion as an Inflammation Hit: Knowns and Unknowns.
abstract: Transfusion of blood cell components is frequent in the therapeutic arsenal; it is globally safe or even very safe. At present, residual clinical manifestations are principally inflammatory in nature. If some rare clinical hazards manifest as acute inflammation symptoms of various origin, most of them linked with conflicting and undesirable biological material accompanying the therapeutic component (infectious pathogen, pathogenic antibody, unwanted antigen, or allergen), the general feature is subtler and less visible, and essentially consists of alloimmunization or febrile non-hemolytic transfusion reaction. The present essay aims to present updates in hematology and immunology that help understand how, when, and why subclinical inflammation underlies alloimmunization and circumstances characteristic of red blood cells and - even more frequently - platelets that contribute inflammatory mediators. Modern transfusion medicine makes sustained efforts to limit such inflammatory hazards; efforts can be successful only if one has a clear view of each element's role.
authors.affiliation: Faculty of Medicine of Saint-Etienne, University of Lyon, Saint-Etienne, France; Institut National de la Transfusion Sanguine, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Garraud
authors.affiliation: Faculty of Medicine of Saint-Etienne, University of Lyon , Saint-Etienne , France.
authors.forename: S
authors.initials: S
authors.lastname: Tariket
authors.affiliation: Faculty of Medicine of Saint-Etienne, University of Lyon , Saint-Etienne , France.
authors.forename: C
authors.initials: C
authors.lastname: Sut
authors.affiliation: Faculty of Medicine of Saint-Etienne, University of Lyon, Saint-Etienne, France; Hôpital du Sacré-Coeur, Beirut, Lebanon.
authors.forename: A
authors.initials: A
authors.lastname: Haddad
authors.affiliation: Faculty of Medicine of Saint-Etienne, University of Lyon , Saint-Etienne , France.
authors.forename: C
authors.initials: C
authors.lastname: Aloui
authors.affiliation: Faculty of Medicine of Saint-Etienne, University of Lyon, Saint-Etienne, France; Centre de Transfusion Sanguine, Sousse, Tunisia; Faculty of Pharmacy, University of Monastir, Monastir, Tunisia.
authors.forename: T
authors.initials: T
authors.lastname: Chakroun
authors.affiliation: Faculty of Medicine of Saint-Etienne, University of Lyon, Saint-Etienne, France; Etablissement Français du Sang Rhône-Alpes-Auvergne, Saint-Etienne, France.
authors.forename: S
authors.initials: S
authors.lastname: Laradi
authors.affiliation: Faculty of Medicine of Saint-Etienne, University of Lyon, Saint-Etienne, France; Etablissement Français du Sang Rhône-Alpes-Auvergne, Saint-Etienne, France.
authors.forename: F
authors.initials: F
authors.lastname: Cognasse
keywords: allergy; alloimmunization; blood components; erythrocytes; inflammation; leukocytes; platelets; transfusion