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Transfusion-associated microchimerism: a new complication of blood transfusions in severely injured patients.
Semin Hematol. 2007 Jan; 44(1):24-31.SH

Abstract

Microchimerism, the stable persistence of an allogeneic cell population, can result from allogeneic exposures including blood transfusion. Transfusion-associated microchimerism (TA-MC) appears to be a common but newly recognized complication of blood transfusion. Thus far TA-MC has been detected when severely injured patients are transfused. Injury induces an immunosuppressive and inflammatory milieu in which fresh blood products with replication-competent leukocytes can sometimes cause TA-MC. TA-MC is present in approximately half of transfused severely injured patients at hospital discharge and is not affected by leukoreduction. In approximately 10% of patients, the chimerism from a single blood donor may increase in magnitude over months to years, reaching as much as 2% to 5% of all circulating leukocytes. In this review, we discuss recent studies of TA-MC in the civilian trauma population and the potential for study of TA-MC in the military population, where the severity of injury and freshness of blood products suggest that TA-MC may be even more prominent. We also discuss the need for future studies to address the immunology of TA-MC, its stem cell biology, and its clinical manifestations that have the potential to be either pathologic (autoimmunity, graft-versus-host disease) or therapeutic (tolerance induction, various cell and gene therapies).

Authors+Show Affiliations

Blood Systems Research Institute, San Francisco, CA 94118, USA. wreed@bloodsystems.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

17198844

Citation

Reed, William, et al. "Transfusion-associated Microchimerism: a New Complication of Blood Transfusions in Severely Injured Patients." Seminars in Hematology, vol. 44, no. 1, 2007, pp. 24-31.
Reed W, Lee TH, Norris PJ, et al. Transfusion-associated microchimerism: a new complication of blood transfusions in severely injured patients. Semin Hematol. 2007;44(1):24-31.
Reed, W., Lee, T. H., Norris, P. J., Utter, G. H., & Busch, M. P. (2007). Transfusion-associated microchimerism: a new complication of blood transfusions in severely injured patients. Seminars in Hematology, 44(1), 24-31.
Reed W, et al. Transfusion-associated Microchimerism: a New Complication of Blood Transfusions in Severely Injured Patients. Semin Hematol. 2007;44(1):24-31. PubMed PMID: 17198844.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transfusion-associated microchimerism: a new complication of blood transfusions in severely injured patients. AU - Reed,William, AU - Lee,Tzong-Hae, AU - Norris,Philip J, AU - Utter,Garth H, AU - Busch,Michael P, PY - 2007/1/3/pubmed PY - 2007/2/14/medline PY - 2007/1/3/entrez SP - 24 EP - 31 JF - Seminars in hematology JO - Semin Hematol VL - 44 IS - 1 N2 - Microchimerism, the stable persistence of an allogeneic cell population, can result from allogeneic exposures including blood transfusion. Transfusion-associated microchimerism (TA-MC) appears to be a common but newly recognized complication of blood transfusion. Thus far TA-MC has been detected when severely injured patients are transfused. Injury induces an immunosuppressive and inflammatory milieu in which fresh blood products with replication-competent leukocytes can sometimes cause TA-MC. TA-MC is present in approximately half of transfused severely injured patients at hospital discharge and is not affected by leukoreduction. In approximately 10% of patients, the chimerism from a single blood donor may increase in magnitude over months to years, reaching as much as 2% to 5% of all circulating leukocytes. In this review, we discuss recent studies of TA-MC in the civilian trauma population and the potential for study of TA-MC in the military population, where the severity of injury and freshness of blood products suggest that TA-MC may be even more prominent. We also discuss the need for future studies to address the immunology of TA-MC, its stem cell biology, and its clinical manifestations that have the potential to be either pathologic (autoimmunity, graft-versus-host disease) or therapeutic (tolerance induction, various cell and gene therapies). SN - 0037-1963 UR - https://www.unboundmedicine.com/medline/citation/17198844/Transfusion_associated_microchimerism:_a_new_complication_of_blood_transfusions_in_severely_injured_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0037-1963(06)00234-4 DB - PRIME DP - Unbound Medicine ER -