Donor-specific transfusion with diminished sensitization

Area of Science:

• Immunology
• Transplantation immunology
• Blood transfusion science

Background:

• Donor specific transfusions (DSTs) are used to reduce sensitization to human leukocyte antigen (HLA) antigens before transplantation.
• Traditional DSTs can lead to undesirable immune sensitization.

Purpose of the Study:

• To evaluate the efficacy of DSTs using aged blood in reducing HLA sensitization and improving transplant outcomes.
• To investigate the in vitro changes in blood cell populations during storage and their impact on immune response.

Main Methods:

• Fourteen haploidentical recipients received DSTs with donor blood stored for 1, 3, and 5 weeks.
• Transplantation was performed 22 to 149 days post-DST.
• In vitro studies analyzed changes in T lymphocytes, B cells, and monocytes during blood storage.

Main Results:

• Successful transplantation in 13 out of 14 recipients for 3 to 26 months.
• One patient experienced hyperacute rejection despite a negative crossmatch.
• In vitro studies indicated loss of T lymphocytes and preservation of B cells and monocytes in stored blood.

Conclusions:

• Blood storage appears to diminish T lymphocyte sensitization while preserving immune-stimulating cells.
• DSTs with aged blood may offer a strategy for reducing HLA sensitization and improving transplant success.
• Further studies are needed to elucidate the precise mechanisms involved.