Transfusion-related immunomodulation. Clinical effects and mechanisms of action
Impact of allogeneic blood transfusion upon clinical outcome, length of stay in hospital or intensive care units, infectious complications, deep vein thrombosis, multiple organ failure in recipients was discussed. Possible mechanisms of transfusion- related immunomodulation (TRIM), of allogeneic blood product (red blood cells/RBCs, platelet concentrate/PLTs, fresh frozen plasma/FFP) transfusion to patients were analyzed. The role of leukocyte contamination, apoptotic cells and microparticles, lipids, HLA-molecules, sFas or sFasL and cytokines was underlined as mediators of TRIM. Special attention was paid to factors, releasing from RBCs and PLTs during storage period prior to transfusion to recipients. The authors concluded that TRIM is emerging a real hazard of blood transfusion and analyzed known measures to prevent detrimental effects of TRIM in patients.