Does the inactivation of leukocytes in blood transfusions during and following liver transplantation by gamma-irradiation have an impact on rejection and infection rate?

BACKGROUND: Leukocytes transmitted in blood products exert a variety of immunological side-effects. Experience with bone marrow transplant recipients has shown that these can be induced even by very few cells. In liver transplant recipients, who usually receive large amounts of blood products, the effects of transfused leukocytes with regards to the rates of rejection and infection have not yet been investigated. MATERIAL/METHODS: Twenty liver transplant recipients were prospectively randomized to receive blood products (red blood cells, thrombocytes, fresh frozen plasma) through a leukocyte depletion filter, either irradiated with 40 Gy or not irradiated (10 patients, respectively). During the observation period of 90 days, the incidences of infections and rejections were analyzed. In addition, liver function tests, markers of infection (C reactive protein, lipopolysaccharide binding protein), and subpopulations of lymphocytes (total cell count, CD4/CD8 ratio, CD8CD45RO) were determined. RESULTS: Only one episode of mild rejection occurred (irradiated group). Rates of persistent graft dysfunction and severe infections were similar in both groups. The same applied to liver function tests, parameters of infection, and subpopulations of lymphocytes. CONCLUSIONS: These preliminary results suggest that irradiation of already leukocyte-depleted blood products may not be necessary and beneficial in liver transplant recipients.

Keywords: Blood Transfusion, Adult, Gamma Rays, Graft Rejection - etiology, Infection - etiology, Leukocyte Reduction Procedures, Liver Transplantation - immunology, Prospective Studies, T-Lymphocyte Subsets - immunology