• Valérie Lapierre, Anne Aupérin, Eric Robinet, Christophe Ferrand, Nadia Oubouzar, Dominique Tramalloni, Philippe Saas, Bertrand Debaene, Philippe Lasser, and Pierre Tiberghien.
• Unit of Transfusion Medicine and Hemovigilance, the Biostatistics and Epidemiology Service, the Department of Anesthesia and Reanimation, Gustave Roussy Cancer Institute, Villejuif, France. valerie.lapierre@igr.fr
• Transfusion. 2007 Sep 1; 47 (9): 1691-9.

BackgroundTransfusion of red blood cells (RBCs) has been associated with immunomodulatory effects. Persistence of donor cells in the recipient may be contributive.Study Design And MethodsA randomized single-center trial was conducted to compare microchimerism and immune responses in 35 patients undergoing cancer surgery and transfused perioperatively with either unmodified RBCs (UN-RBCs, n = 18) or leukoreduced RBCs (LR-RBCs, n = 17). Biologic parameters included microchimerism assessment peripheral blood mononuclear cell (PBMNC) phenotyping, cytokine production by stimulated PBMNCs, FoxP3 gene expression, and T-cell repertoire (TCR) analysis.ResultsMicrochimerism was documented in 8 of 18 patients after UN-RBC transfusion while absent after LR-RBC transfusion (0/17; p = 0.001). After UN-RBC transfusion, microchimerism was associated with increased interleukin (IL)-10 production (p = 0.02), reduced TCR alteration (p = 0.04), and reduced CD56+ cell counts (p = 0.02) when compared to recipients without evidence for microchimerism. FoxP3 gene expression did not differ significantly between both treatment groups nor with the presence or absence of microchimerism in the UN-RBC group. Finally, after an initial early decrease after surgery and transfusion, IL-12 production increased and more significantly so after UN-RBC transfusion versus LR-RBC transfusion (p = 0.05).ConclusionUN-RBC-induced microchimerism is associated with specific immunomodulatory effects in cancer patients who received transfusions during surgery.

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