High Risk of Transfusion-induced Alloimmunization of Patients with Inflammatory Bowel Disease

Papay, Pavol; Hackner, Klaus; Vogelsang, Harald; Novacek, Gottfried; Primas, Christian; Reinisch, Walter; Eser, Alexander; Mikulits, Andrea; Mayr, Wolfgang R.; Körmöczi, Günther F.

doi:10.1016/j.amjmed.2011.11.028

Cited by 47 publications

(43 citation statements)

References 31 publications

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“…Although there have been reports in humans that examined the relationship between inflammation as part of autoimmune disorders (Ramsey & Smietana, 1995;Tyler et al, 2007;Papay et al, 2012), disseminated infections (Hata et al, 2013) and febrile transfusion reactions (Yazer et al, 2009) on RBC alloimmunization, the effect of the inflammatory status of transfusion recipients on RBC alloimmunization has not been thoroughly investigated in patients with SCD. The influence of SCD-related complications considered to be proinflammatory on alloimmunization rates is currently unknown.…”

Section: Discussionmentioning

confidence: 99%

Red blood cell alloimmunization is influenced by recipient inflammatory state at time of transfusion in patients with sickle cell disease

et al. 2014

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SummarySickle cell disease (SCD) patients are at increased risk of red blood cell (RBC) alloimmunization. Recipient inflammatory state at time of transfusion has been shown to regulate alloimmunization in murine models, but evidence is lacking in SCD patients. We retrospectively studied a cohort of alloimmunized SCD patients to determine the influence of pro-inflammatory SCD-related complications at time of transfusion on alloimmunization. For each transfusion, the presence of pro-inflammatory state, degree of RBC antigen matching, unit age, storage solution and alloantibody detection date were ascertained. Transfusion-associated pro-inflammatory events were compared between transfusions resulting and not resulting in new alloantibodies. Univariate analysis and multivariate logistic regression were performed. Fifty-two patients received 3166 pre-storage leuco-reduced transfusions of which 128 resulted in alloantibodies. Transfusions during inflammatory events were associated with increased alloantibody risk on univariate and multivariate analysis; acute chest syndrome and vaso-occlusive crisis showed strongest associations with alloimmunization. Increased antigen matching demonstrated a protective effect on alloimmunization (univariate and multivariate analysis). Although an association was seen between citrate-phosphate-dextrose (adenine) stored units and alloimmunization on univariate analysis, no effect was found on multivariate analysis. Identifying recipient pro-inflammatory states at time of transfusion that promote alloimmunization can impact RBC unit selection decisions for SCD patients at risk for alloimmunization.

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Section: Discussionmentioning

confidence: 99%

Red blood cell alloimmunization is influenced by recipient inflammatory state at time of transfusion in patients with sickle cell disease

et al. 2014

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“…Its rate is roughly proportional to the number of the transfusions received [20,21,22]. Not surprisingly, patients suffering from diseases that depend on chronic transfusion support have especially high RBCA rates [18,23].…”

Section: Nature and Dose Of Red Blood Cell Antigensmentioning

confidence: 99%

“…Conversely, disease- or therapy-associated immunosuppression results in decreased or even abolished tendency to develop RBCA [22,48,49]. Especially immunosuppressed solid organ transplant recipients subjected to immunosuppressive protocols to avoid or treat graft rejection have a markedly impaired alloimmune response with minimal RBCA rates [50,51,52].…”

Section: Clinical Factors Influencing Red Blood Cell Alloimmunizationmentioning

confidence: 99%

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Responder Individuality in Red Blood Cell Alloimmunization

Körmöczi

Mayr²

2014

Transfus Med Hemother

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Many different factors influence the propensity of transfusion recipients and pregnant women to form red blood cell alloantibodies (RBCA). RBCA may cause hemolytic transfusion reactions, hemolytic disease of the fetus and newborn and may be a complication in transplantation medicine. Antigenic differences between responder and foreign erythrocytes may lead to such an immune answer, in part with suspected specific HLA class II associations. Biochemical and conformational characteristics of red blood cell (RBC) antigens, their dose (number of transfusions and pregnancies, absolute number of antigens per RBC) and the mode of exposure impact on RBCA rates. In addition, individual circumstances determine the risk to form RBCA. Responder individuality in terms of age, sex, severity of underlying disease, disease- or therapy-induced immunosuppression and inflammation are discussed with respect to influencing RBC alloimmunization. For particular high-risk patients, extended phenotype matching of transfusion and recipient efficiently decreases RBCA induction and associated clinical risks.

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“…There is evidence that an inflammatory state in the recipient favors the occurrence of alloimmunization in mice [37][38][39] and possibly in humans [40], and that some recipients are responders (they respond easily to alloimmune stimulation) while others are non-responders.…”

Section: Recipient Related Factors In Transfusionmentioning

confidence: 99%

From Donor to Recipient: Current Questions Relating to Humoral Alloimmunization

et al. 2014

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Alloimmunization is an undesirable iatrogenic effect of transfusion and transplantation. In fact, recipients can be considered as responders or not responders, in a continuum from tolerance, including organ transplantation and transfusion, to polyimmunized and refractory patients. New models and large studies have enabled a better understanding of the mechanisms that induce specific alloantibody (alloAb) generation. Here, we focus on risk factors of alloimmunization. We review the alloantibody characteristics, summarize the different leukocytes involved in their induction, and suggest some hypotheses.

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High Risk of Transfusion-induced Alloimmunization of Patients with Inflammatory Bowel Disease

Cited by 47 publications

References 31 publications

Red blood cell alloimmunization is influenced by recipient inflammatory state at time of transfusion in patients with sickle cell disease

Red blood cell alloimmunization is influenced by recipient inflammatory state at time of transfusion in patients with sickle cell disease

Responder Individuality in Red Blood Cell Alloimmunization

From Donor to Recipient: Current Questions Relating to Humoral Alloimmunization

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