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Transfusion‐related immunomodulation: review of the literature and implications for pediatric critical illness
Author(s) -
Muszynski Jennifer A.,
Spinella Philip C.,
Cholette Jill M.,
Acker Jason P.,
Hall Mark W.,
Juffermans Nicole P.,
Kelly Daniel P.,
Blumberg Neil,
Nicol Kathleen,
Liedel Jennifer,
Doctor Allan,
Remy Kenneth E.,
Tucci Marisa,
Lacroix Jacques,
Norris Philip J.
Publication year - 2017
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.13855
Subject(s) - medicine , critical illness , immune system , immunology , intensive care medicine , intensive care unit , critically ill , blood product , proinflammatory cytokine , inflammation , pathology
Transfusion‐related immunomodulation (TRIM) in the intensive care unit (ICU) is difficult to define and likely represents a complicated set of physiologic responses to transfusion, including both proinflammatory and immunosuppressive effects. Similarly, the immunologic response to critical illness in both adults and children is highly complex and is characterized by both acute inflammation and acquired immune suppression. How transfusion may contribute to or perpetuate these phenotypes in the ICU is poorly understood, despite the fact that transfusion is common in critically ill patients. Both hyperinflammation and severe immune suppression are associated with poor outcomes from critical illness, underscoring the need to understand potential immunologic consequences of blood product transfusion. In this review we outline the dynamic immunologic response to critical illness, provide clinical evidence in support of immunomodulatory effects of blood product transfusion, review preclinical and translational studies to date of TRIM, and provide insight into future research directions.