Immune response to autologous transfusion in healthy volunteers: WB versus packed RBCs and FFP

Authors

  • Thomas Frietsch,

    1. From the Departments of Anesthesiology and Critical Care Medicine and of Clinical Chemistry, Faculty of Clinical Medicine Mannheim; and the Institute of Immunology, University of Heidelberg, Mannheim, Germany.
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  • Heiko Fessler,

    1. From the Departments of Anesthesiology and Critical Care Medicine and of Clinical Chemistry, Faculty of Clinical Medicine Mannheim; and the Institute of Immunology, University of Heidelberg, Mannheim, Germany.
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  • Michael Kirschfink,

    1. From the Departments of Anesthesiology and Critical Care Medicine and of Clinical Chemistry, Faculty of Clinical Medicine Mannheim; and the Institute of Immunology, University of Heidelberg, Mannheim, Germany.
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  • Thomas Nebe,

    1. From the Departments of Anesthesiology and Critical Care Medicine and of Clinical Chemistry, Faculty of Clinical Medicine Mannheim; and the Institute of Immunology, University of Heidelberg, Mannheim, Germany.
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  • Klaus F. Waschke,

    1. From the Departments of Anesthesiology and Critical Care Medicine and of Clinical Chemistry, Faculty of Clinical Medicine Mannheim; and the Institute of Immunology, University of Heidelberg, Mannheim, Germany.
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  • Arnulf Lorentz

    1. From the Departments of Anesthesiology and Critical Care Medicine and of Clinical Chemistry, Faculty of Clinical Medicine Mannheim; and the Institute of Immunology, University of Heidelberg, Mannheim, Germany.
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  • Supported by a grant from the Faculty of Clinical Medicine Mannheim, University of Heidelberg.

Address reprint requests to: Thomas Frietsch, MD, Department of Anesthesiology and Intensive Care Medicine, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Theodor Kutzer Ufer 1 - 3, D-68167 Mannheim, Germany; e-mail: Thomas.Frietsch@urz.uni-heidelberg.de.

Abstract

BACKGROUND: Storage of blood as packed RBCs and FFP is standard practice in allogeneic transfusion. Separation into components has been proposed for autologous transfusion, as well, but beneficial effects have not yet been shown.

STUDY DESIGN AND METHODS: Twenty-four healthy male volunteers were randomly assigned to receive 1 unit of either autologous RBCs and FFP (RCP group) or WB (WB group) after 49 or 35 days of storage, respectively. The immune response was analyzed by ELISA for IL-6, C3a, terminal complement complex SC5b-9, TNF-α, and neopterin. Differential WBC counts and the phagocytosis of neutrophils and monocytes were measured by flow cytometry.

RESULTS: Cell counts of monocytes (0.85 × 103 ng/mL) and neutrophils (6.9 × 103 ng/mL) increased 30 minutes after WB transfusion and then returned to close to the baseline values seen in the RCP group (0.47 and 2.9 × 103 ng/mL, respectively) throughout the monitored period (p<0.05). C3a (169 vs. 116 ng/mL) and IL-6 (29 vs. 6 pg/mL) reached higher plasma concentrations in the WB group (n = 11) than in the RCP group (n = 10). Phagocytosis of opsonized Escherichia coli was increased in neutrophils and monocytes and lasted up to 7 days after the transfusion of whole blood.

CONCLUSION: Autologous WB induces a modest immunomodulation, but this effect is not observed upon transfusion of autologous blood components.

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