Transfusion-related immunomodulation: review of the literature and implications for pediatric critical illness

for the Pediatric Critical Care Blood Research Network (Blood Net)

Research output: Contribution to journalReview article

47 Scopus citations

Abstract

Transfusion-related immunomodulation (TRIM) in the intensive care unit (ICU) is difficult to define and likely represents a complicated set of physiologic responses to transfusion, including both proinflammatory and immunosuppressive effects. Similarly, the immunologic response to critical illness in both adults and children is highly complex and is characterized by both acute inflammation and acquired immune suppression. How transfusion may contribute to or perpetuate these phenotypes in the ICU is poorly understood, despite the fact that transfusion is common in critically ill patients. Both hyperinflammation and severe immune suppression are associated with poor outcomes from critical illness, underscoring the need to understand potential immunologic consequences of blood product transfusion. In this review we outline the dynamic immunologic response to critical illness, provide clinical evidence in support of immunomodulatory effects of blood product transfusion, review preclinical and translational studies to date of TRIM, and provide insight into future research directions.

Original languageEnglish (US)
Pages (from-to)195-206
Number of pages12
JournalTransfusion
Volume57
Issue number1
DOIs
StatePublished - Jan 1 2017

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Hematology

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