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Transfusion-associated microchimerism in combat casualties.

James R Dunne¹, Tzong-Hae Lee, Christopher Burns

¹Department of General Surgery, National Naval Medical Center, Bethesda, MD 20889, USA. james.dunne@med.navy.mil

The Journal of Trauma

|April 11, 2008

Summary

Transfusion-associated microchimerism (TA-MC) occurred in 45% of transfused soldiers, similar in fresh whole blood and platelet recipients compared to red blood cell recipients. Further research is needed to understand clinical consequences.

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Area of Science:

Immunology
Transfusion Medicine
Trauma Surgery

Background:

Fresh whole blood (FrWB) is standard for combat casualty resuscitation.
High rates of transfusion-associated microchimerism (TA-MC) are noted in civilian trauma patients.
This study compares TA-MC incidence in combat casualties receiving FrWB versus standard red blood cell (RBC) transfusions.

Purpose of the Study:

To determine the incidence of TA-MC in combat casualties treated with FrWB.
To compare TA-MC rates between FrWB recipients and those receiving standard RBC transfusions.
To investigate potential clinical implications of TA-MC in a military trauma population.

Main Methods:

Prospective collection of TA-MC data at >=14 days posttransfusion.
Study included 26 severely injured combat casualties.
Demographic and transfusion variables were analyzed.

Main Results:

TA-MC was present in 45% (10 of 22) of transfused patients.
Incidence was 50% in FrWB recipients and 38% in RBC-only recipients (p=0.61).
Platelet recipients also showed 50% TA-MC incidence.

Conclusions:

Preliminary data show no significant difference in TA-MC rates between FrWB, platelet, and RBC recipients.
The overall 45% TA-MC rate in transfused soldiers warrants further investigation.
Potential clinical consequences, including graft-versus-host disease and autoimmune syndromes, require study.