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J Reconstr Microsurg 2005; 21(8): 555-564
DOI: 10.1055/s-2005-922436
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Role of Blood Transfusion in Transplantation: A Review

Maria Siemionow1 , Galip Agaoglu1
  • 1Department of Plastic Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio
Further Information

Publication History

Accepted: July 14, 2005

Publication Date:
17 November 2005 (online)

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ABSTRACT

The ultimate goal of transplantation immunology is induction of donor-specific tolerance without the need for chronic immunosuppression. A number of strategies have been used to induce tolerance, including donor-specific blood transfusion (DST). A large number of experimental and clinical studies have evaluated the ability of DST to induce tolerance in solid organ transplantation. In contrast, a limited number of experimental studies have been reported evaluating the effect of DST in induction of tolerance in composite tissue allograft transplants.

DST applications include cadaveric and living-related graft recipients in humans, leading to achievement of microchimerism. Although the mechanism of action is still uncertain, microchimerism with the concomitant persistence of soluble donor HLA antigen is considered to be the most significant contributing factor.

In this article, the experimental and clinical applications, as well as the immunomodulatory mechanism of DST, are reviewed.

KEYWORDS

Donor-specific blood transfusion - composite tissue allograft - tolerance strategies

REFERENCES

  • 1 Opelz G, Sengar D P, Mickey M R, Terasaki P I. Effect of blood transfusions on subsequent kidney transplants.  Transplant Proc. 1973;  5 253-259
    PubMedSearch in Google Scholar
  • 2 Brynger H, Frisk B, Ahlmen J. Graft survival and blood transfusion. In: Robinson BH Proceedings of the XIV Congress of the European Dialysis and Transplant Association. Kent, England; Pitman Medical Publishing Co 1997: 290-295
    Search in Google Scholar
  • 3 Pfaff W W, Fennell R S, Howard R J. Planned random donor blood transfusion in preparation for transplantation.  Transplantation. 1984;  38 701-703
    PubMedSearch in Google Scholar
  • 4 Okazaki H, Maki T, Wood M L. Effect of blood transfusions on skin allograft survival in immunosuppressed mice.  Transplant Proc. 1981;  13 515-517
    PubMedSearch in Google Scholar
  • 5 Frisk B, Brynger H, Sandberg L. Two random transfusions before primary renal transplantation-four years experience from a single center.  Transplant Proc. 1982;  14 386-388
    PubMedSearch in Google Scholar
  • 6 Faver C, Jeannet M, Harder F. Blood transfusions, cytotoxic antibodies, and kidney graft survival.  Transplantation. 1979;  28 343-346
    PubMedSearch in Google Scholar
  • 7 Salvatierra O, Vincenti F, Ahmend W J. What about blood transfusions in living related transplantation? Abstracts of the American Society of Nephrology, Twelfth Annual Meeting. Boston, Massachusetts; 1979: 178A
    Search in Google Scholar
  • 8 Kerman R H, Susskind B, Katz S M, Van Buren C T, Kahan B D. Post renal transplant MLR hypo-responders have fewer rejections and better graft survival than MLR hyper-responders.  Transplant Proc. 1997;  29 1410-1411
    CrossrefPubMedSearch in Google Scholar
  • 9 Kerman R H, Katz S M, Schoenberg L, Baraket O, Van Buren C T, Kahan B D. 10-year follow up of MLR-hyporesponsive living related cyclosporine monotherapy treated renal allograft recipients.  Transplant Proc. 1997;  29 198-199
    CrossrefPubMedSearch in Google Scholar
  • 10 Jackson A, McSherry C, Butters K et al.. Pretransplant exposure to donor HLA-DR antigen in random transfusion units and the development of donor antigen-specific hyporeactivity.  Human Immunology. 1997;  55 148-153
    CrossrefPubMedSearch in Google Scholar
  • 11 Salvatierra O, Vincenti F, Amend W et al.. Deliberate donor-specific blood transfusions prior to living related renal transplantation: a new approach.  Ann Surg. 1980;  192 544
    PubMedSearch in Google Scholar
  • 12 Opelz G, Terasaki P I. Dominant effect of transfusions on kidney graft survival.  Transplantation. 1980;  29 153-158
    PubMedSearch in Google Scholar
  • 13 Salvatierra O, Vincenti F, Ahmend W JC. Four year experience with donor-specific blood transfusions.  Transplant Proc. 1983;  15 924
    PubMedSearch in Google Scholar
  • 14 Potter D, Garovoy M, Hopper S et al.. Effect of donor specific transfusion on renal transplantation.  Pediatrics. 1985;  76 402-405
    PubMedSearch in Google Scholar
  • 15 Broyer M, Gagnadoux M, Guest G et al.. Kidney transplantation in children: results of 383 grafts performed at Enfants Malades Hospital from 1973-1984. In: Hamgurger J, Grosnier J, Grunfeld P, Maxwell MD Advances in Nephrology. Chicago, IL; Year Book Medical Publishers 1987 307
    Search in Google Scholar
  • 16 Chavers B M, Nevins T E, Knaack M et al.. Early acute tubular necrosis, late rejection in pediatric renal transplantation with donor specific transfusion.  Transplant Proc. 1987;  19 1526-1527
    PubMedSearch in Google Scholar
  • 17 Kahan B D, Van Buren C T, Flechner S M, Payne W D, Boileau M, Kerman R H. Cyclosporine immunosuppression mitigates immunologic risk factors in renal allotransplantation.  Transplant Proc. 1983;  15 2469-2478
    PubMedSearch in Google Scholar
  • 18 Lundgren G, Albrechtsen D, Flatmark A et al.. HLA-matching and pretransplant blood transfusions in cadaveric renal transplantation-a changing picture with cyclosporin.  Lancet. 1986;  2 66-69
    PubMedSearch in Google Scholar
  • 19 Opelz G. Improved kidney graft survival in nontransfused recipients.  Transplant Proc. 1987;  19 149-152
    PubMedSearch in Google Scholar
  • 20 Cecka J M, Cicciarelli J, Mickey M R, Terasaki P I. Blood transfusions and HLA matching-an either/or situation in cadaveric renal transplantation.  Transplantation. 1988;  45 81-86
    PubMedSearch in Google Scholar
  • 21 Dubernard J M, Owen E, Herzberg G et al.. Human hand allograft: report on first 6 months.  Lancet.. 1999;  353 1315-1320
    CrossrefPubMedSearch in Google Scholar
  • 22 Siemionow M, Gozel-Ulusal B, Engin Ulusal A et al.. Functional tolerance following face transplantation in the rat.  Transplantation.. 2003;  75 1607-1609
    PubMedSearch in Google Scholar
  • 23 Siemionow M, Oke R, Ozer K et al.. Induction of donor-specific tolerance in rat hind-limb allografts under antilymphocyte serum and cyclosporine A protocol.  J Hand Surg. 2002;  27A 1095-1103
    PubMedSearch in Google Scholar
  • 24 Buttemeyer R, Jones N F, Min Z et al.. Rejection of the component tissues of limb allografts in rats immunosuppressed with FK-506 and cyclosporine.  Plast Reconstr Surg. 1996;  97 139-148
    PubMedSearch in Google Scholar
  • 25 Kamel G, Stephan A, Masri M A et al.. Donor-specific transfusion under the new cyclosporine A formulation Consupren versus azathioprine, Imuran.  Transplant Proc. 1997;  29 2960-2961
    CrossrefPubMedSearch in Google Scholar
  • 26 Whelchel J D, Shaw J F, Curtis J J, Luke R G, Diethelm A G. Effect of pretransplant stored donor-specific blood transfusions on early renal allograft survival in one-haplotype living related transplants.  Transplantation. 1982;  34 326-329
    PubMedSearch in Google Scholar
  • 27 Cheigh J S, Suthanthiran M, Fotino M et al.. Minimal sensitization and excellent renal allograft outcome following donor-specific blood transfusion with a short course of cyclosporine.  Transplant Proc. 1991;  23 1023
    PubMedSearch in Google Scholar
  • 28 Otsuka M, Yuzawa K, Takada Y et al.. Long-term graft survival of living-related kidneys after donor-specific transfusion.  Transplant Proc. 2000;  32 1741-1742
    CrossrefPubMedSearch in Google Scholar
  • 29 Black K S, Hewitt C W, Woodard T L et al.. Efforts to enhance survival of limb allografts by prior administration of whole blood in rats using a new survival end-point.  J Microsurg. 1982;  3 162-167
    PubMedSearch in Google Scholar
  • 30 Balshi J D, Francfort J W, Perloff L J. The influence of ultraviolet irradiation on the blood transfusion effect.  Surgery. 1985;  98 243-250
    PubMedSearch in Google Scholar
  • 31 Lasek W, Jakóbisiak M, Plodzisewska M, Szczytnicki W, Górecki D. The role of drug timing and histoincompatibility barrier in prolongation of cardiac graft survival in mice treated with donor-specific blood and cyclophosphamide.  Immunology Letters. 1988;  17 357-360
    CrossrefPubMedSearch in Google Scholar
  • 32 Bradley J A. The blood transfusion effect: experimental aspects.  Immunology Letters. 1991;  29 127-132
    CrossrefPubMedSearch in Google Scholar
  • 33 Sato K, Yabuki K, Haba T, Maekawa T. Role of Kupffer Cells in the induction of tolerance after liver transplantation.  J Surg Res. 1996;  63 433-438
    CrossrefPubMedSearch in Google Scholar
  • 34 Sato Y, Farges O, Buffello D, Hatakeyama K, Bismuth H. Cytokine mRNA expression in the liver after administration of donor leukocytes.  Transplant Proc. 1998;  30 3855-3857
    CrossrefPubMedSearch in Google Scholar
  • 35 Antoniou E A, Drayson M, Howie A J, McMaster P, D'Silva M. Effect of donor-specific transfusion in combination with FK506 in rat cardiac allotransplantation.  Transplant Proc. 1999;  31 2796-2798
    CrossrefPubMedSearch in Google Scholar
  • 36 Morin N, Lamoureux E, Lipman M, Tector J, Tchervenkov J I, Metrakos P. Donor-specific portal transfusion augments microchimerism in a porcine model of small bowel transplantation.  Transplant Proc. 2000;  32 1290-1291
    CrossrefPubMedSearch in Google Scholar
  • 37 Fecteau A H, Tchervenkov J I, Guttman F M, Takara T, Rosenmann E. Small bowel transplantation: the effect of intraportal donor-specific transfusion 24 hours pretransplant and low-dose cyclosporine Transplantation.  1994;  58 399-402
    PubMedSearch in Google Scholar
  • 38 Martinelli G P, Chung-Loy R, Sher L. Long-term prolongation of cardiac allografts by subtherapeutic levels of cyclosporine in rats conditioned with pretransplant blood transfusions and cyclosporine.  Transplantation. 1985;  39 1-5
    PubMedSearch in Google Scholar
  • 39 Yasumura T, Kahan B D. Prolongation of rat kidney allografts by pretransplant administration of donor antigen extract or whole blood transfusion combined with a short course of cyclosporine.  Transplantation. 1983;  36 603-609
    PubMedSearch in Google Scholar
  • 40 Ahmed S M, Baslaim G, Eshelby D, Guttmann R D, Tchervenkov J I. The effect of transfusion with donor-specific peripheral lymphocytes, whole blood or erythrocytes on cardiac allograft survival in cyclosporine-treated rats.  Transplantation. 1994;  57 634-637
    PubMedSearch in Google Scholar
  • 41 Ringers J, Ossevoort M, Haanstra K, Kroczek R, Volk D, Jonker M. Blockade of CD154 at the time of donor-specific blood transfusion does not improve kidney graft survival in rhesus monkeys.  Transplant Proc. 2001;  33 524
    CrossrefPubMedSearch in Google Scholar
  • 42 Antoniou E A, Drayson M, Howie A J, McMaster P, D'Silva M. Donor-specific blood transfusion does not enhance the effect of FTY720 in rat cardiac allotransplantation.  Transplant Proc. 1998;  30 1042-1043
    CrossrefPubMedSearch in Google Scholar
  • 43 Oluwole S F, Fawwaz R A, Reemtsma K, Hardy M A. Induction of donor-specific unresponsiveness to rat cardiac allograft by donor leukocytes and cyclosporine.  Transplantation. 1988;  45 1131-1135
    PubMedSearch in Google Scholar
  • 44 Kahan B D. Cosmas and Damian revisited.  Transplant Proc. 1983;  15 2211-2216
    PubMedSearch in Google Scholar
  • 45 Lapchinsky A G, Eingorn A G, Uratkov E F. Homotransplantation of extremities in tolerant dogs observed up to seven years.  Transplant Proc. 1973;  5 773-779
    PubMedSearch in Google Scholar
  • 46 Kim S K, Aziz S, Oyer P, Hentz V R. Use of cyclosporin A in allotransplantation of rat limbs.  Ann Plast Surg. 1984;  12 249-255
    PubMedSearch in Google Scholar
  • 47 Stark G B, Swartz W M, Narayanan K, Moller A R. Hand transplantation in baboons.  Transplant Proc. 1987;  19 3968-3971
    PubMedSearch in Google Scholar
  • 48 Daniel R K, Egerszegi E P, Samulack D D, Skanes S E, Dykes R W, Rennie W R. Tissue transplants in primates for upper extremity reconstruction: a preliminary report.  J Hand Surg. 1986;  11 1-8
    PubMedSearch in Google Scholar
  • 49 Hotokebuchi T, Arai K, Takagishi K, Arita C, Sugioka Y, Kaibara N. Limb allografts in rats immunosuppressed with cyclosporine: as a whole-joint allograft.  Plast Reconstr Surg. 1989;  83 1027-1038
    PubMedSearch in Google Scholar
  • 50 Kniha H, Randzio J, Gold M E et al.. Growth of forelimb allografts in young rabbits immunosuppressed with cyclosporine.  Ann Plast Surg. 1989;  22 135-141
    PubMedSearch in Google Scholar
  • 51 Xu H, Montgomery S P, Preston E H et al.. Studies investigating pretransplant donor-specific blood transfusion, rapamycin, and the CD154-specific antibody IDEC-131 in a nonhuman primate model of skin allotransplantation.  J Immunol.. 2003;  170 2776-2782
    PubMedSearch in Google Scholar
  • 52 Nomoto K, Kanoh K, Suzuki H, Shimura T, Kuwano H. Mechanism of hyporesponsiveness caused by donor-specific transfusion to allogeneic minor antigens.  Eur Surg Res.. 2001;  33 217-224
    CrossrefPubMedSearch in Google Scholar
  • 53 Barbari A, Stephan A, Masri M A, Joubran N, Dagher O, Kamel G. Donor specific transfusion in kidney transplantation: effect of different immunosuppressive protocols on graft outcome.  Transplant Proc. 2001;  33 2787-2788
    CrossrefPubMedSearch in Google Scholar
  • 54 Kong J M, Jeong J H, Kang J K, Seong I G, Kim B C. Donor-specific transfusion in living related and unrelated donor kidney transplantation: minimal sensitization and excellent graft outcome.  Transplant Proc. 1995;  27 1036-1037
    PubMedSearch in Google Scholar
  • 55 Sharma R K, Pai P K, Kumar A et al.. Morphological and morphometric studies on liver in rats subjected to repetitive heat stress.  Nephron. 1997;  75 20-26
    PubMedSearch in Google Scholar
  • 56 Woodle E S, Newell K A, Haas M et al.. Reversal of accelerated renal allograft rejection with FK506.  Clin Transplant. 1997;  11 251-254
    PubMedSearch in Google Scholar
  • 57 Lyne J C, Vivas C A, Shapiro R et al.. Cadaveric renal transplantation against a positive crossmatch under tacrolimus immunosuppression: long-term follow-up.  Transplant Proc. 1997;  29 312
    CrossrefPubMedSearch in Google Scholar
  • 58 Sato Y, Watanabe H, Yamamoto S et al.. Role of recipient CD56+ CD3+ cells in the graft in living-related partial liver transplantation.  Transplant Proc. 2000;  32 2131-2132
    CrossrefPubMedSearch in Google Scholar
  • 59 Terasaki P I, Cecka J M, Gjertson D W, Takemoto S. High survival rates of kidney transplants from spousal and living unrelated donors.  N Engl J Med. 1995;  333 333-336
    CrossrefPubMedSearch in Google Scholar
  • 60 Okazaki H, Sato T, Miura S, Amada N. Donor-specific blood transfusion in living-related renal transplantation: fourteen-year experience.  Transplant Proc. 1997;  29 200-202
    CrossrefPubMedSearch in Google Scholar
  • 61 Miura S, Okazaki H, Satoh T, Amada N, Ohashi Y. Long-term follow-up of living donor renal transplant recipients sensitized after donor specific blood transfusion.  Transplant Proc. 2001;  33 1221-1223
    CrossrefPubMedSearch in Google Scholar
  • 62 Chen D, Sung R, Bromberg J S. Gene therapy in transplantation.  Transplant Immunology. 2000;  9 301-314
    PubMedSearch in Google Scholar
  • 63 Liang J, Yamaguchi Y, Matsuda T et al.. Posttransplant infusion of donor-specific blood induces immunological unresponsiveness in rat hepatic allografts.  Transplantation. 2000;  70 1363-1371
    PubMedSearch in Google Scholar
  • 64 Marquet R L, Heystek G A. Induction of suppressor cells by donor-specific blood transfusions and heart transplantation in rats.  Transplantation. 1981;  31 272-274
    PubMedSearch in Google Scholar
  • 65 Terasaki P I. The beneficial transfusion effect on kidney graft survival attributed to clonal deletion.  Transplantation. 1984;  37 119-125
    PubMedSearch in Google Scholar
  • 66 Wendel T D. The beneficial effect of donor-specific transfusions: a review of existing explanations and a new hypothesis based on a relatively unapplied theory of T cell immunoregulation. A regulatory hypothesis in progress.  Med Hypotheses.. 2000;  54 922-943
    CrossrefPubMedSearch in Google Scholar
  • 67 Leivestad T, Thorsby E. Effects of HLA-haploidentical blood transfusions on donor-specific immune responsiveness.  Transplantation. 1984;  37 175-181
    PubMedSearch in Google Scholar
  • 68 Suciu-Foca N, Reed E, Rohowsky C, Kung P, King D W. Anti-idiotypic antibodies to anti-HLA receptors induced by pregnancy.  Proc Natl Acad Sci USA. 1983;  80 830-834
    PubMedSearch in Google Scholar
  • 69 Kishimoto K, Yuan X, Auchincloss Jr H, Sharpe A H, Mandelbrot D A, Sayegh M H. Mechanism of action of donor-specific transfusion in inducing tolerance: role of donor MHC molecules, donor co-stimulatory molecules, and indirect antigen presentation.  J Am Soc Nephrol. 2004;  15 2423-2428
    CrossrefPubMedSearch in Google Scholar
  • 70 Roelen D L, van Rood J J, Brand A, Claas F H. Immunomodulation by blood transfusions.  Vox Sang. 2000;  78 Suppl 2 273-275
    PubMedSearch in Google Scholar
  • 71 Roelen D, Brand A, Claas F H. Pretransplant blood transfusions revisited: a role for CD(4+) regulatory T cells?.  Transplantation. 2004;  77(1 Suppl) S26-S28
    PubMedSearch in Google Scholar
  • 72 Burlingham W J, Grailer A P, Fechner J H et al.. Microchimerism linked to cytotoxic T lymphocyte functional unresponsiveness (clonal anergy) in a tolerant renal transplant recipient.  Transplantation. 1995;  59 1147-1155
    PubMedSearch in Google Scholar
  • 73 Mincheff M S, Meryman H T, Kapoor V et al.. Blood transfusion and immunomodulation: A possible mechanism.  Vox Sang. 1993;  65 18-24
    PubMedSearch in Google Scholar
  • 74 Macleod A M, Hillis A N, Mather A, Bone J M, Catto G R. Effect of cyclosporin, previous third-party transfusion, and pregnancy on antibody development after donor-specific transfusion before renal transplantation.  Lancet. 1987;  329 416-418
    CrossrefPubMedSearch in Google Scholar
  • 75 Horuzsko A, Gyó E, Réti M et al.. Non-cytotoxic blocking antibodies and suppressor cells induced by donor-specific transfusions in healthy volunteers and potential kidney transplant recipients.  Immunology Letters. 1990;  26 127-130
    CrossrefPubMedSearch in Google Scholar
  • 76 Josien R, Douillard P, Guillot C et al.. A critical role for transforming growth factor-beta in donor transfusion-induced allograft tolerance.  J Clin Invest. 1998;  102 1920-1926
    PubMedSearch in Google Scholar
  • 77 Lagaaij E L, Hennemann I P, Ruigrok M et al.. Effect of one-HLA-DR-antigen-matched and completely HLA-DR-mismatched blood transfusions on survival of heart and kidney allografts.  N Engl J Med. 1989;  321 701-705
    PubMedSearch in Google Scholar
  • 78 Mast B J, Balk A H. Effect of HLA-DR-shared blood transfusion on the clinical outcome of heart transplantation.  Transplantation.. 1997;  63 1514-1519
    PubMedSearch in Google Scholar
  • 79 Starzl T E, Demetris A J, Murase N, Ildstad S, Ricordi C, Trucco M. Cell migration, chimerism, and graft acceptance.  Lancet. 1992;  339 1579-1582
    CrossrefPubMedSearch in Google Scholar
  • 80 Starzl T E, Demetris A J, Trucco M et al.. Cell migration and chimerism after whole-organ transplantation: the basis of graft acceptance.  Hepatology. 1993;  17 1127-1152
    CrossrefPubMedSearch in Google Scholar
  • 81 Murase N, Starzl T E, Ye Q et al.. Multilineage hematopoietic reconstitution of supralethally irradiated rats by syngeneic whole organ transplantation: with particular reference to the liver.  Transplantation. 1996;  61 1-4
    PubMedSearch in Google Scholar
  • 82 Taniguchi H, Toyoshima T, Fukao K, Nakauchi H. Presence of hematopoietic stem cells in the adult liver.  Nat Med. 1996;  2 198-203
    PubMedSearch in Google Scholar
  • 83 Schlitt H J, Kanehiro H, Raddatz G et al.. Persistence of donor lymphocytes in liver allograft recipients.  Transplantation. 1993;  56 1001-1007
    PubMedSearch in Google Scholar
  • 84 Demetris A J, Murase N, Starzl T E. Donor dendritic cells after liver and heart allotransplantation under short term immunosuppression.  Lancet. 1992;  339 1610-1611
    PubMedSearch in Google Scholar
  • 85 Claas F. Towards clinical transplantation tolerance.  Lancet. 2003;  361 1489-1490
    CrossrefPubMedSearch in Google Scholar
  • 86 Fandrich F, Lin X, Zhu X, Kloppel G, Parwaresch R, Kremer B. CD95L confers immune privilege to liver grafts which are spontaneously accepted.  Transplant Proc. 1998;  30 1057-1058
    CrossrefPubMedSearch in Google Scholar
  • 87 Sharland A, Shastry S, Wang C et al.. Kinetics of intragraft cytokine expression, cellular infiltration, and cell death in rejection of renal allografts compared with acceptance of liver allografts in a rat model.  Transplantation. 1998;  65 1370-1377
    PubMedSearch in Google Scholar
  • 88 Shirwan H, Wang C, Barwari L, Cramer D V. Recipient-donor microchimerism is not a prerequisite for the maintenance of allograft tolerance.  Transplant Proc. 1997;  61 1182-1183
    PubMedSearch in Google Scholar
  • 89 Sivasai K SR, Alevy Y G, Duffy B F et al.. Peripheral blood microchimerism in human liver and renal transplant recipients.  Transplantation. 1997;  64 427-432
    CrossrefPubMedSearch in Google Scholar
  • 90 Ito H, Hamano K, Gohra H et al.. Role of microchimerism on long-term graft survival after donor-specific transfusion in a rat heart transplantation model.  Transplant Proc. 1998;  30 3862-3864
    CrossrefPubMedSearch in Google Scholar
  • 91 Huang Y, Xia J, Yang C, Ye S, Ye Y. IL-10 gene expression and cardiac allograft survival with or without treatment of monoclonal antibodies, CsA, donor-specific transfusion after rat heart transplantation.  J Heart Lung Transplant. 2002;  21 129
    PubMedSearch in Google Scholar
  • 92 Kataoka M, Margenthaler J A, Ku G, Flye M W. Development of infectious tolerance after donor-specific transfusion and rat heart transplantation.  J Immunol.. 2003;  171 204-211
    PubMedSearch in Google Scholar
  • 93 Ichiguchi O, Yamaguchi Y, Akizuki E et al.. Prolonged survival of rat hepatic allografts treated with a pretransplant donor-specific blood transfusion is associated with reduced cytokine-induced neutrophil chemoattractant expression.  Transplantation. 1998;  65 465-472
    PubMedSearch in Google Scholar
  • 94 Oya H, Sato Y, Ichida T et al.. Changes in serum cytokine levels and donor-specific transfusion via portal vein during the early period following living related donor liver transplantation.  Transplant Proc. 2003;  35 409
    CrossrefPubMedSearch in Google Scholar
  • 95 Takeuchi T, Lowry R P, Konieczny B. Heart allografts in murine systems. The differential activation of Th2-like effector cells in peripheral tolerance Transplantation.  1992;  53 1281-1294
    PubMedSearch in Google Scholar
  • 96 Bugeon L, Cuturi M C, Hallet M M, Paineau J, Chabannes D, Soulillou J P. Peripheral tolerance of an allograft in adult rats-characterization by low interleukin-2 and interferon-gamma mRNA levels and by strong accumulation of major histocompatibility complex transcripts in the graft.  Transplantation. 1992;  54 219-225
    PubMedSearch in Google Scholar
  • 97 Josien R, Doullard P, Guillot C et al.. A critical role for transforming growth factor-beta in donor transfusion-induced allograft tolerance.  J Clin Invest.. 1998;  102 1920-1926
    PubMedSearch in Google Scholar
  • 98 Inuzuka S, Koga S, Nishikido M et al.. Donor-specific blood transfusion prolongs cardiac allograft survival in rats by low nitric oxide production and elevated serum levels of prostaglandin E2 .  Immunology Letters. 2002;  83 119-124
    CrossrefPubMedSearch in Google Scholar
  • 99 Langrehr J M, Dull K E, Ochoa J B et al.. Evidence that nitric oxide production by in vivo allosensitized cells inhibits the development of allospecific CTL Transplantation.  1992;  53 632-640
    PubMedSearch in Google Scholar
  • 100 Ichiguchi O, Yamaguchi Y, Goto M et al.. A significant reduction of macrophages expressing inducible nitric oxide synthase in rat hepatic allografts pretreated with donor-specific blood.  Transplantation. 1998;  65 776-785
    PubMedSearch in Google Scholar
  • 101 Rodiles M, Chadee K. Novel regulation of cyclooxygenase-2 expression and prostaglandin E2 production by IFN-gamma in human macrophages.  J Immunol. 1998;  161 2441-2448
    PubMedSearch in Google Scholar
  • 102 Koga S, Luke P P, Specht S M et al.. Inhibition of the allograft response by donor specific blood transfusion: association with reduced local TH1 cytokines and nitric oxide but enhanced prostaglandin E2 production.  Transplantation. 2000;  70 1788-1796
    PubMedSearch in Google Scholar
  • 103 Plaut M, Marone G, Gillespie E. The role of cyclic AMP in modulating cytotoxic T lymphocytes. II. Sequential changes during culture in responsiveness of cytotoxic lymphocytes to cyclic AMP-active agents.  J Immunol. 1983;  131 2945-2952
    PubMedSearch in Google Scholar
  • 104 Betz M, Fox B S. Prostaglandin E2 inhibits production of Th1 lymphokines but not of Th2 lymphokines.  J Immunol. 1991;  146 108-113
    PubMedSearch in Google Scholar
  • 105 Goto T, Herberman R B, Maluish A, Strong D M. Cyclic AMP as a mediator of prostaglandin E-induced suppression of human natural killer cell activity.  J Immunol. 1983;  130 1350-1355
    PubMedSearch in Google Scholar
  • 106 Kunkel S L, Chensue S W, Phan S H. Prostaglandins as endogenous mediators of interleukin 1 production.  J Immunol. 1986;  136 186-192
    PubMedSearch in Google Scholar
  • 107 Snyder D S, Beller D I, Unanue E R. Prostaglandins modulate macrophage Ia expression Nature.  1982;  299 163-165
    PubMedSearch in Google Scholar
  • 108 Shelby J, Marushack M M, Nelson E W. Prostaglandin production and suppressor cell induction in transfusion-induced immune suppression Transplantation.  1987;  43 113-116
    PubMedSearch in Google Scholar
  • 109 Yaron I, Jin M X, Oluwole S F, Hardy M A. Importance of the relative resistance of cord blood CD34+ cells to UVB in bone marrow transplantation.  Transplant Proc. 1997;  29 739
    CrossrefPubMedSearch in Google Scholar
  • 110 Yu S, Tu Y, Flye M W. The shift of Th1/Th2 ratios induced by portal venous administration of UVB-treated donor spleen cells prolonged mouse cardiac allografts.  Transplant Proc. 1997;  29 1162
    CrossrefPubMedSearch in Google Scholar
  • 111 Anderson C B, Tyler J D, Sicard G A et al.. Pretreatment of renal allograft recipients with immunosuppression and donor specific blood.  Transplantation. 1984;  38 664-668
    PubMedSearch in Google Scholar
  • 112 Fehrman I, Groth C G, Lundgren G, Moller E. Improved renal graft survival in transfused uremics. A result of a number of interacting factors.  Transplantation. 1980;  30 324-327
    PubMedSearch in Google Scholar
  • 113 Ettenger R B, Kerman R, Arnett L et al.. Sensitization following donor specific transfusions for living-related renal transplantation.  Transplant Proc. 1983;  15 943
    PubMedSearch in Google Scholar
  • 114 Morris P J. Kidney transplantation, principles and practice. In: Fine RN, Bajaj G Renal Transplantation in Children. 5th ed. Philadelphia, PA; WB Saunders 2001 622
    Search in Google Scholar
  • 115 Miura S, Okazaki H, Sato T, Amada N, Sakurada M. Successful renal transplantation in presensitized recipients with double-filtration plasmapheresis and 15-deoxyspergualin.  Transplant Proc. 1997;  29 350-351
    CrossrefPubMedSearch in Google Scholar
  • 116 Sato Y, Farges O, Buffello D, Hatakeyama K, Bismuth H. Impact of 70% partial hepatectomy on administration of donor leukocytes in cardiac transplantation in rats.  Transplant Proc. 1998;  30 3873-3875
    CrossrefPubMedSearch in Google Scholar
  • 117 Iwaki Y, Cecka J M, Terasaki P I. The transfusion effect in cadaver kidney transplants-yes or no.  Transplantation. 1990;  49 56-59
    PubMedSearch in Google Scholar
  • 118 Cicciarelli J S. UNOS Registry data: effect of transfusions. In: Terasaki PI Clinical Transplants. Los Angeles, CA; UCLA Tissue Typing Laboratory 1990 407
    Search in Google Scholar
  • 119 Ahmed Z, Terasaki P I. Effect of transfusion. In: Terasaki PI, Cecka MJ Clinical Transplants, 1991. Los Angeles, CA; UCLA Tissue Typing Laboratory 1992: 305
    Search in Google Scholar
  • 120 Chertow G M, Milford E L. Pre-transplant blood transfusion and cadaveric renal allograft outcome: data from the United Network of Organ Sharing (UNOS).  J Am Soc Nephol. 1995;  16 1077
    PubMedSearch in Google Scholar
  • 121 Opelz G, Vanrenter ghem Y, Kriste G et al.. Prospective evaluaton of pretransplant blood transfusions in cadaver kidney recipients.  Transplantation. 1997;  63 964-967
    PubMedSearch in Google Scholar
  • 122 Alexander J W, Light J A, Donaldson L A et al.. Evaluation of pre- and posttransplant donor specific transfusion/cyclosporine A in non-HLA identical living donor kidney transplant recipients. Cooperative clinical trials in transplantation research group.  Transplantation. 1999;  68 1117-1124
    PubMedSearch in Google Scholar

Maria SiemionowM.D. Ph.D. D.Sc. 

Department of Plastic Surgery, A60 The Cleveland Clinic Foundation

9500 Euclid Avenue, Cleveland, OH 44195