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Immunologic changes after transfusion of autologous or allogeneic buffy coat‐poor versus white cell‐reduced blood to patients undergoing arthroplasty. I. Proliferative T‐cell responses and the balance of helper and suppressor T cells
Author(s) -
Innerhofer P.,
Luz G.,
Spötl L.,
HobischHagen P.,
Schobersberger W.,
Fischer M.,
Nussbaumer W.,
Lochs A.,
Irschick E.
Publication year - 1999
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.1999.39101089.x
Subject(s) - buffy coat , medicine , immunology , white blood cell , t cell , cd8 , perioperative , andrology , red blood cell , immune system , surgery
BACKGROUND: Donor white cells (WBCs) contained in red cell (RBC) transfusions are thought to provoke down‐regulation of T‐cell‐mediated immunity. This study investigated this topic in otherwise healthy patients receiving buffy coat‐depleted or WBC‐filtered RBCs and undergoing standardized perioperative management. STUDY DESIGN AND METHODS: Patients undergoing elective orthopedic surgery (primary hip and knee replacement surgery) were enrolled in a prospective study. Perioperative changes in T‐cell proliferation (stimulation with phytohemagglutinin and mixed lymphocyte culture) and T‐cell balance (T‐lymphocytes, helper T cells, and suppressor T cells) were compared after random assignment to allogeneic buffy coat‐depleted (Group 2, n = 8) or WBC‐reduced RBC (Group 3, n = 11) transfusion regimens. Recipients of autologous buffy coat‐depleted RBC transfusions (n = 15) served as controls (Group 1). RESULTS: Compared to that in autologous transfusion recipients, alloantigen‐induced T‐cell proliferation was significantly reduced in recipients of allogeneic WBC‐reduced RBCs (Day 3, p = 0.0274). After the transfusion of allogeneic buffy coat‐depleted RBCs, a weak trend toward decreased T‐cell proliferation was observed (p = 0.0933) and the numbers of CD4 + T cells were also significantly lower (Day 7, p = 0.0389). On Day 10, alloantigen‐induced T‐cell proliferation remained significantly below baseline after transfusion of WBC‐reduced RBCs (p = 0.05), the numbers of CD3 + cells decreased in allogeneic RBC recipients (Group 2, p = 0.078; Group 3, p = 0.05), and those of CD8 + cells decreased significantly after the transfusion of allogeneic buffy coat‐depleted RBCs (p = 0.0234) concomitant with an increased CD4:CD8 ratio (p = 0.0391). CONCLUSION: Results of the present study confirm the hypothesis of impaired T‐cell‐mediated immunity after allogeneic transfusion.