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

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• 作者：Jennifer A. Muszynski ; Philip C. Spinella ; Jill M. Cholette ; Jason P. Acker ; Mark W. Hall ; Nicole P. Juffermans ; Daniel P. Kelly ; Neil Blumberg ; Kathleen Nicol ; Jennifer Liedel ; Allan Doctor ; Kenneth E. Remy ; Marisa Tucci ; Jacques Lacroix ; Philip J. Norris and for the Pediatric Critical Care Blood Research Network (Blood Net)
• 刊名：Transfusion
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：57
• 期：1
• 页码：195-206
• 全文大小：182K
• ISSN：1537-2995

文摘

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.