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Microchimerism decades after transfusion among combat-injured US veterans from the Vietnam, Korean, and World War II conflicts

Authors

  • Garth H. Utter,

    1. From the Department of Surgery, University of California, Davis, Medical Center, Sacramento, California; Blood Systems Research Institute, and the Department of Laboratory Medicine, University of California, San Francisco, California.
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  • Tzong-Hae Lee,

    1. From the Department of Surgery, University of California, Davis, Medical Center, Sacramento, California; Blood Systems Research Institute, and the Department of Laboratory Medicine, University of California, San Francisco, California.
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  • Ryan M. Rivers,

    1. From the Department of Surgery, University of California, Davis, Medical Center, Sacramento, California; Blood Systems Research Institute, and the Department of Laboratory Medicine, University of California, San Francisco, California.
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  • Lani Montalvo,

    1. From the Department of Surgery, University of California, Davis, Medical Center, Sacramento, California; Blood Systems Research Institute, and the Department of Laboratory Medicine, University of California, San Francisco, California.
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  • Li Wen,

    1. From the Department of Surgery, University of California, Davis, Medical Center, Sacramento, California; Blood Systems Research Institute, and the Department of Laboratory Medicine, University of California, San Francisco, California.
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  • Daniel M. Chafets,

    1. From the Department of Surgery, University of California, Davis, Medical Center, Sacramento, California; Blood Systems Research Institute, and the Department of Laboratory Medicine, University of California, San Francisco, California.
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  • William F. Reed,

    1. From the Department of Surgery, University of California, Davis, Medical Center, Sacramento, California; Blood Systems Research Institute, and the Department of Laboratory Medicine, University of California, San Francisco, California.
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  • Michael P. Busch

    1. From the Department of Surgery, University of California, Davis, Medical Center, Sacramento, California; Blood Systems Research Institute, and the Department of Laboratory Medicine, University of California, San Francisco, California.
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  • This project was supported by Grant R01-HL-083388 from the National Heart, Lung, and Blood Institute. The study was also funded in part by a grant from Blood Systems Foundation, Scottsdale, AZ.

Garth H. Utter, MD, MSc, Department of Surgery, University of California, Davis, Medical Center, 2315 Stockton Boulevard, Room 4206 MH, Sacramento, CA 95817; e-mail: garth.utter@ucdmc.ucdavis.edu.

Abstract

BACKGROUND: Blood transfusion after traumatic injury can result in microchimerism (MC) of donor white cells (WBCs) in the recipient as late as 2 to 3 years postinjury, the longest prospective follow-up to date. The purpose of this study was to determine how long transfusion-associated MC lasts after traumatic injury.

STUDY DESIGN AND METHODS: A group of US combat veterans who received transfusions who responded to a recruitment notice was retrospectively evaluated. Their blood was sampled, and MC was assessed by quantitative allele-specific polymerase chain reaction detection of differences at the HLA-DR locus or a panel of insertion-deletion polymorphism loci. Results of veterans were compared to those from an age- and gender-matched blood donor control group, from whom WBCs were retrieved from leukoreduction filters.

RESULTS: Among 163 combat veterans who received transfusion and 150 control subjects who did not receive transfusions, 16 (9.8%) of the veterans and 1 (0.7%) control subject had evidence of MC (relative risk, 14.7; 95% confidence interval, 2.0-110). The veterans with MC included 3 who served in WWII (7% of subjects from that conflict), 5 in Korea (18%), and 6 in Vietnam (7%).

CONCLUSIONS: Transfusion for combat-related injury can result in MC that lasts for 60 years, suggesting that it may involve permanent engraftment. MC is rare among male blood donors who did not receive transfusions, who are probably representative of individuals who have not had postnatal allogeneic exposures.

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