Lack of persistent microchimerism in contemporary transfused trauma patients

Rachael P. Jackman, Garth H. Utter, Tzong Hae Lee, Lani Montalvo, Li Wen, Dan Chafets, Ryan M. Rivers, Patricia M. Kopko, Philip J. Norris, Michael P. Busch

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

BACKGROUND: Following transfusion, donor white blood cells (WBCs) can persist long-term in the recipient, a phenomenon termed transfusion-associated microchimerism (TA-MC). Prior studies suggest TA-MC is limited to transfusion following traumatic injury, and is not prevented by leukoreduction. STUDY DESIGN AND METHODS: We conducted a prospective cohort study at a major trauma center to evaluate TA-MC following injury. Index samples were collected upon arrival, prior to transfusion. Follow-up samples were collected at intervals up to one year, and beyond for those testing positive for TA-MC. TA-MC was detected by real-time quantitative allele-specific polymerase chain reaction assays at the HLA-DR locus and several polymorphic insertion deletion sites screening for non-recipient alleles. RESULTS: A total of 378 trauma patients were enrolled (324 transfused cases and 54 non-transfused controls). Mean age was 42 ± 18 years, 74% were male, and 80% were injured by blunt mechanism. Mean Injury Severity Score was 20 ± 12. Among transfused patients, the median (interquartile range) number of red cell units transfused was 6 (3,12), and median time to first transfusion was 9 (0.8,45) hours. Only one case of long-term TA-MC was confirmed in our cohort. We detected short-term TA-MC in 6.5% of transfused subjects and 5.6% on non-transfused controls. CONCLUSIONS: In contrast to earlier studies, persistent TA-MC was not observed in our cohort of trauma subjects. Short-term TA-MC was detected, but at a lower frequency than previously observed, and rates were not significantly different than what was observed in non-transfused controls. The reduction in TA-MC occurrence may be attributable to changes in leukoreduction or other blood processing methods.

Original languageEnglish (US)
JournalTransfusion
DOIs
StateAccepted/In press - Jan 1 2019

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Hematology

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    Jackman, R. P., Utter, G. H., Lee, T. H., Montalvo, L., Wen, L., Chafets, D., Rivers, R. M., Kopko, P. M., Norris, P. J., & Busch, M. P. (Accepted/In press). Lack of persistent microchimerism in contemporary transfused trauma patients. Transfusion. https://doi.org/10.1111/trf.15518