Flesland Oystein, Ip Lisa S K, Storlien Anne S, Spurkland Anne, Larsen Jonn, Solheim Bjarte G
Institute of Immunology, Rikshospitalet University Hospital, Oslo NO-0023, Norway; Blood Bank, Asker and Baerum Hospital, Rud NO-1309, Norway.
Transfus Apher Sci. 2004 Dec;31(3):173-80. doi: 10.1016/j.transci.2004.07.012.
Microchimerism may play a part in transfusion complications. The aim of this study was to examine whether establishment of post-transfusion microchimerism was related to leukocyte content.
Twenty non-pregnant female patients, without known malignant or immunological diseases, mean age 68 years, receiving 2-4 units of red blood cell concentrates during elective surgery, were included. One or two of the units were from male donors. Ten patients received buffy-coat depleted red blood cell concentrates, leukocyte count 108-109 per unit, and 10 patients received red blood cells leukoreduced by prestorage leukocyte filtration, with a leukocyte count of <106 per unit. EDTA samples were collected in vacuum tubes before and after 1 week and 6 months after transfusion. The tubes were frozen and stored at -400 degrees C. Genomic DNA was isolated and PCR performed using four primer sets amplifying markers on the Y-chromosome.
Microchimerism was detected in a total of eight out of the 20 patients. In three patients microchimerism was detected only before transfusion. These patients had given birth to one or two boys each, and had no history of previous transfusion. Two patients receiving buffy-coat depleted red blood cell concentrates and two patients receiving leukoreduced red blood cell concentrates had detectable microchimerism 1 week after transfusion. The age of the transfused red blood cell concentrates was 6, 24, 8 and 7 days, respectively. One patient receiving leukoreduced red blood cell concentrates had detectable microchimerism after 6 months. The age of this concentrate was 22 days.
This study demonstrates that microchimerism after transfusion does not seem to be dose dependent, and can be induced even by a >3 week old leukoreduced red blood cell concentrate with a very low leukocyte content.
微嵌合体可能在输血并发症中起作用。本研究的目的是检查输血后微嵌合体的形成是否与白细胞含量有关。
纳入20名非妊娠女性患者，她们无已知的恶性或免疫性疾病，平均年龄68岁，在择期手术期间接受2 - 4单位的红细胞浓缩液。其中1或2个单位来自男性供者。10名患者接受去除白细胞层的红细胞浓缩液，每单位白细胞计数为10⁸ - 10⁹，10名患者接受预储存白细胞过滤白细胞减少的红细胞，每单位白细胞计数<10⁶。在输血前、输血后1周和6个月采集乙二胺四乙酸（EDTA）样本于真空管中。将试管冷冻并储存在 - 40℃。分离基因组DNA并使用四组引物进行聚合酶链反应（PCR），扩增Y染色体上的标记物。
20名患者中共有8名检测到微嵌合体。3名患者仅在输血前检测到微嵌合体。这些患者每人曾生育1或2个男孩，且既往无输血史。2名接受去除白细胞层红细胞浓缩液的患者和2名接受白细胞减少红细胞浓缩液的患者在输血后1周检测到可检测到的微嵌合体。所输注红细胞浓缩液的储存时间分别为6天、24天、8天和7天。1名接受白细胞减少红细胞浓缩液的患者在6个月后检测到可检测到的微嵌合体。该浓缩液的储存时间为22天。
本研究表明输血后的微嵌合体似乎不依赖剂量，即使是储存超过3周、白细胞含量极低的白细胞减少红细胞浓缩液也可诱导产生微嵌合体。
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