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Lack of persistent microchimerism in contemporary transfused trauma patients.
Transfusion. 2019 11; 59(11):3329-3336.T

Abstract

BACKGROUND

Following transfusion, donor white blood cells (WBCs) can persist long-term in the recipient, a phenomenon termed transfusion-associated microchimerism (TA-MC). Prior studies suggest TA-MC is limited to transfusion following traumatic injury, and is not prevented by leukoreduction.

STUDY DESIGN AND METHODS

We conducted a prospective cohort study at a major trauma center to evaluate TA-MC following injury. Index samples were collected upon arrival, prior to transfusion. Follow-up samples were collected at intervals up to one year, and beyond for those testing positive for TA-MC. TA-MC was detected by real-time quantitative allele-specific polymerase chain reaction assays at the HLA-DR locus and several polymorphic insertion deletion sites screening for non-recipient alleles.

RESULTS

A total of 378 trauma patients were enrolled (324 transfused cases and 54 non-transfused controls). Mean age was 42 ± 18 years, 74% were male, and 80% were injured by blunt mechanism. Mean Injury Severity Score was 20 ± 12. Among transfused patients, the median (interquartile range) number of red cell units transfused was 6 (3,12), and median time to first transfusion was 9 (0.8,45) hours. Only one case of long-term TA-MC was confirmed in our cohort. We detected short-term TA-MC in 6.5% of transfused subjects and 5.6% on non-transfused controls.

CONCLUSIONS

In contrast to earlier studies, persistent TA-MC was not observed in our cohort of trauma subjects. Short-term TA-MC was detected, but at a lower frequency than previously observed, and rates were not significantly different than what was observed in non-transfused controls. The reduction in TA-MC occurrence may be attributable to changes in leukoreduction or other blood processing methods.

Authors+Show Affiliations

Vitalant Research Institute, San Francisco, California. University of California, San Francisco, California.University of California, Davis, Medical Center, Sacramento, California.Vitalant Research Institute, San Francisco, California.Vitalant Research Institute, San Francisco, California.Vitalant Research Institute, San Francisco, California.Vitalant Research Institute, San Francisco, California.University of California, Davis, Medical Center, Sacramento, California.University of California, San Diego, California.Vitalant Research Institute, San Francisco, California. University of California, San Francisco, California.Vitalant Research Institute, San Francisco, California. University of California, San Francisco, California.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

31518003

Citation

Jackman, Rachael P., et al. "Lack of Persistent Microchimerism in Contemporary Transfused Trauma Patients." Transfusion, vol. 59, no. 11, 2019, pp. 3329-3336.
Jackman RP, Utter GH, Lee TH, et al. Lack of persistent microchimerism in contemporary transfused trauma patients. Transfusion. 2019;59(11):3329-3336.
Jackman, R. P., Utter, G. H., Lee, T. H., Montalvo, L., Wen, L., Chafets, D., Rivers, R. M., Kopko, P. M., Norris, P. J., & Busch, M. P. (2019). Lack of persistent microchimerism in contemporary transfused trauma patients. Transfusion, 59(11), 3329-3336. https://doi.org/10.1111/trf.15518
Jackman RP, et al. Lack of Persistent Microchimerism in Contemporary Transfused Trauma Patients. Transfusion. 2019;59(11):3329-3336. PubMed PMID: 31518003.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lack of persistent microchimerism in contemporary transfused trauma patients. AU - Jackman,Rachael P, AU - Utter,Garth H, AU - Lee,Tzong-Hae, AU - Montalvo,Lani, AU - Wen,Li, AU - Chafets,Dan, AU - Rivers,Ryan M, AU - Kopko,Patricia M, AU - Norris,Philip J, AU - Busch,Michael P, Y1 - 2019/09/13/ PY - 2019/05/15/received PY - 2019/07/08/revised PY - 2019/08/11/accepted PY - 2019/9/14/pubmed PY - 2020/6/9/medline PY - 2019/9/14/entrez SP - 3329 EP - 3336 JF - Transfusion JO - Transfusion VL - 59 IS - 11 N2 - BACKGROUND: Following transfusion, donor white blood cells (WBCs) can persist long-term in the recipient, a phenomenon termed transfusion-associated microchimerism (TA-MC). Prior studies suggest TA-MC is limited to transfusion following traumatic injury, and is not prevented by leukoreduction. STUDY DESIGN AND METHODS: We conducted a prospective cohort study at a major trauma center to evaluate TA-MC following injury. Index samples were collected upon arrival, prior to transfusion. Follow-up samples were collected at intervals up to one year, and beyond for those testing positive for TA-MC. TA-MC was detected by real-time quantitative allele-specific polymerase chain reaction assays at the HLA-DR locus and several polymorphic insertion deletion sites screening for non-recipient alleles. RESULTS: A total of 378 trauma patients were enrolled (324 transfused cases and 54 non-transfused controls). Mean age was 42 ± 18 years, 74% were male, and 80% were injured by blunt mechanism. Mean Injury Severity Score was 20 ± 12. Among transfused patients, the median (interquartile range) number of red cell units transfused was 6 (3,12), and median time to first transfusion was 9 (0.8,45) hours. Only one case of long-term TA-MC was confirmed in our cohort. We detected short-term TA-MC in 6.5% of transfused subjects and 5.6% on non-transfused controls. CONCLUSIONS: In contrast to earlier studies, persistent TA-MC was not observed in our cohort of trauma subjects. Short-term TA-MC was detected, but at a lower frequency than previously observed, and rates were not significantly different than what was observed in non-transfused controls. The reduction in TA-MC occurrence may be attributable to changes in leukoreduction or other blood processing methods. SN - 1537-2995 UR - https://www.unboundmedicine.com/medline/citation/31518003/Lack_of_persistent_microchimerism_in_contemporary_transfused_trauma_patients_ L2 - https://doi.org/10.1111/trf.15518 DB - PRIME DP - Unbound Medicine ER -