Translational research

Project leader: Jaap-Jan Zwaginga MD PhD

Unraveling increased mortality by leukocyte-containing transfusions during cardiac surgery (project leaders: LMG van de Watering, A Brand) by cytokine induction was studied in 346 cardiac valve surgery patients, who had participated in an RCT comparing buffy coat versus filtered erythrocyte transfusions. Pre- and post-surgery cytokine levels were determined. Multivariate analysis showed higher IL-6 concentrations associated with multiple organ dysfunction syndrome and both higher IL-6 and IL-10 concentrations associated with hospital mortality in the group that had received multiple non-leukocyte-depleted RBC compared to the group that received LD-RBC. These findings suggest that leukocyte-containing RBC interfere with the postoperative cytokine pro- and anti-inflammatory cytokine cascade, which may enhance the development of complications after cardiac surgery. Further analysis on the role of leukocytes in blood transfusions was evaluated in transplant patients (project leaders: FHJ Claas, A Brand) and showed by functional and microarray decreased immune effector mechanisms and regulatory effects by HLA-DR shared transfusions, whereas in presensitized patients prolonged memory T cell reactivity was observed (Eikmans et al., 2010).

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