Microchimerism in Ghanaian children recipients of whole blood transfusion for severe anaemia

Abstract

Background and objectives Transfusion‐acquired microchimerism (TA‐Mc) has been reported in major trauma but not in young children despite relative immunodeficiency who, in sub‐Saharan Africa, often suffer severe anaemia related to haemoglobinopathies or primary malaria infections. We examined the hypothesis that such massive red cell destructions might provide conditions favourable to TA‐Mc, particularly when exposed to massive amounts of parasite antigens. Materials and Methods Twenty‐seven female children <5 years transfused with male whole blood for severe anaemia (13 with acute malaria and 14 with other causes) were retrospectively identified, and a blood sample was collected >6 months post‐transfusion. Four whole blood samples from paediatric females transfused with blood from female donors and five secondary school female students never pregnant, never transfused were used as negative controls. Results Nineteen patients (70%) carried male Mc with four (15%) having high levels of Mc (>100 genome equivalent of male cells/million of host cells) compared to three controls (37·5%). There was no difference in frequency or quantity of male Mc between paediatric patients with severe malaria and paediatric patients with other causes of severe anaemia. TA‐Mc was not correlated with patient age, duration of whole blood storage or lymphocyte load transfused. After a median of 7 months post‐transfusion, acute malaria did not increase the frequency of TA‐Mc. One negative control appeared to carry low‐level male cells. Conclusion Transfusion‐acquired microchimerism appears frequent in young children transfused with whole blood for severe anaemia.

Clinical Effect of Microneedle Injection Combined with Blood Transfusion in the Treatment of Severe Anemia Complicated with Vitiligo under Regenerative Medical Technology

“…The incidence of vitiligo increases notably when patients are in a state of disease or poor physical condition [11,12]. Anemia can lead to low immunity and slow metabolism, and vitiligo, as a disease that is difficult to cure, has a high possibility of relapse [13,14]. Moreover, the history of vitiligo and anemia increases the risk of vitiligo relapse.…”

Lack of persistent microchimerism in contemporary transfused trauma patients

“…If, however, this hypothesis is correct, TA-MC may continue to occur in other populations of transfused trauma patients, as blood processing and leukoreduction methods vary considerably. However, in resource limited settings where leukoreduction is not performed due to cost and logistics, and particularly settings where fresh whole blood transfusions are routinely employed for trauma, young children with severe anemia, and other indications, TA-MC will likely continue to occur (as documented in a recent study from Ghana), 15 and hence continued studies are warranted of incidence and potential adverse or beneficially consequences of TA-MC.…”

“…This altered environment may be a key factor in enabling the establishment of persistent microchimerism. The one example of TA‐MC occurring outside of traumatic injury is from a recent study that found evidence of microchimerism in pediatric recipients of whole blood in Ghana . While the study was small and had some limitations, the finding is compelling and merits further study.…”