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Long-term detection of microchimaerism in peripheral blood after pretransplantation blood transfusion
S F Vervoordeldonk1, K Doumaid, E B Remmerswaal
1Central Laboratory of The Netherlands Red Cross Blood Transfusion Service, University of Amsterdam.
Abstract:
Renal allograft survival is prolonged after pretransplantation blood transfusion. The aim of this study was to test retrospectively the development and persistence of microchimaerism after pretransplantation blood transfusion and to assess whether the type of blood transfusion (partially matched [= sharing of at least one HLA-B and one HLA-DR antigen between blood donor and recipient] versus mismatched) influences the (continued) presence of donor-type cells. A sensitive nested PCR technique based on HLA-DRB1 allele-specific amplification using sequence-specific primers (detection level: one donor cell among 10(5) recipient cells) for detection of donor cells was implemented in our laboratory. We studied 21 patients for microchimaerism in the peripheral blood compartment, following blood transfusion. Our preliminary data show that microchimaerism was detectable up to 8 weeks after blood transfusion. In all patients receiving a partially matched blood transfusion, donor-type cells were detected in the first week after transfusion, in 7/8 patients 2-4 weeks after transfusion, and in some patients up to 8 weeks after transfusion. After mismatched transfusion a tendency to shorter duration of microchimaerism was observed.
Insights
Pretransplantation blood transfusions can prolong renal allograft survival by establishing microchimerism. Partially matched transfusions show longer persistence of donor cells compared to mismatched transfusions.
Area of Science:
- Immunology
- Transplantation Medicine
- Genetics
Background:
- Pretransplantation blood transfusions are known to improve renal allograft survival.
- The mechanism, specifically the persistence of donor cells (microchimerism), requires further investigation.
Purpose of the Study:
- To retrospectively analyze the development and persistence of microchimerism after pretransplantation blood transfusions.
- To determine if partially matched versus mismatched transfusions affect donor cell presence.
Main Methods:
- Utilized a sensitive nested PCR technique with HLA-DRB1 allele-specific primers.
- Detected donor cells at a level of 1 donor cell per 10(5) recipient cells.
- Studied microchimerism in the peripheral blood of 21 patients post-transfusion.
Main Results:
- Microchimerism was detectable up to 8 weeks post-transfusion.
- In partially matched transfusions, donor cells were present in the first week, and in 7/8 patients at 2-4 weeks, with some persisting up to 8 weeks.
- Mismatched transfusions showed a trend towards shorter microchimerism duration.
Conclusions:
- Pretransplantation blood transfusions lead to detectable microchimerism.
- Partially matched transfusions appear to support a more sustained presence of donor cells compared to mismatched transfusions.