Transfusion-Associated Microchimerism in Individuals Receiving a Blood Transfusion After a Traumatic Injury

Wounds and Injuries Clinical Trial

Official title:

Prospective Study of the Kinetics and Mechanisms of Transfusion-associated Microchimerism in Injured Patients

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00400192
• Other study ID #: 1362
• Secondary ID: R01HL083388
• Status: Completed
• Phase: N/A
• First received: November 15, 2006
• Last updated: April 11, 2013
• Start date: November 2006
• Est. completion date: July 2012

Study information

• Verified date: April 2013
• Source: Blood Systems Research Institute
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Federal Government
• Study type: Observational

Clinical Trial Summary

Individuals who experience a traumatic injury often have a significant amount of blood loss and may require a blood transfusion. In some individuals who receive a blood transfusion, white blood cells from the donor's blood may remain in the body for years, a condition known as microchimerism. This study will examine the reasons why microchimerism occurs in some blood transfusion recipients and not others.

Description:

Approximately 20% of individuals who suffer a traumatic injury require a blood transfusion; of these, 10% to 15% experience a condition known as transfusion-associated microchimerism. This occurs when white blood cells, or leukocytes, from the donor's blood persist in the recipient long after the transfusion occurs. The genetically distinct donor cells can remain in the individual for decades, and may account for as many as 4% of the white blood cells in the recipient's body. This suggests that the donor cells are tolerated by the recipient's immune system. The purpose of this study is to examine the specific factors that predispose some blood transfusion recipients to develop microchimerism.

In this study, blood samples will be collected from injured individuals who arrive at the University of California at Davis Medical Center. Individuals who receive a blood transfusion, as well as a control group of individuals who do not receive a transfusion, will be approached to enroll in the study. Individuals who agree to participate will have their blood collected at Days 7, 14, and 28 and Months 3 and 6. Study researchers will analyze the blood for evidence of microchimerism. Participants with microchimerism will undergo additional blood collection at Months 12, 18, 24, 30, and 36. Information will be collected from all participants on health status, injury characteristics, hospital care, blood transfusion details, and blood donor characteristics.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 451
• Est. completion date: July 2012
• Est. primary completion date: August 2010
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 12 Years and older

Eligibility

Inclusion Criteria:

• Hospitalized for a traumatic injury

• Received at least one unit of transfused red blood cells

Exclusion Criteria:

• Currently incarcerated

• Inadequate decision-making capacity of the participant and no available surrogate decision-maker

• Prior bone marrow or solid organ transplantation

Study Design

Observational Model: Cohort, Time Perspective: Prospective

Related Conditions & MeSH terms

• Blood Transfusion
• Chimerism
• Wounds and Injuries

Locations

Country	Name	City	State
United States	University of California, Davis, Medical Center	Sacramento	California

Sponsors (2)

Lead Sponsor	Collaborator
Blood Systems Research Institute	National Heart, Lung, and Blood Institute (NHLBI)

Country where clinical trial is conducted

United States, 

References & Publications (3)

Lee TH, Paglieroni T, Utter GH, Chafets D, Gosselin RC, Reed W, Owings JT, Holland PV, Busch MP. High-level long-term white blood cell microchimerism after transfusion of leukoreduced blood components to patients resuscitated after severe traumatic injury. Transfusion. 2005 Aug;45(8):1280-90. — View Citation

Utter GH, Owings JT, Lee TH, Paglieroni TG, Reed WF, Gosselin RC, Holland PV, Busch MP. Blood transfusion is associated with donor leukocyte microchimerism in trauma patients. J Trauma. 2004 Oct;57(4):702-7; discussion 707-8. — View Citation

Utter GH, Owings JT, Lee TH, Paglieroni TG, Reed WF, Gosselin RC, Holland PV, Busch MP. Microchimerism in transfused trauma patients is associated with diminished donor-specific lymphocyte response. J Trauma. 2005 May;58(5):925-31; discussion 931-2. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Prevalence and magnitude of transfusion-associated microchimerism		1, 2 and 4 weeks, 3 and 6 months	No