Blood, Vol. 95 No. 8 (April 15), 2000:
pp. 2709-2714
Survival of donor cells 25 years after intrauterine transfusion
Henk E. Viëtor,
Eric Hallensleben,
Simone P. M. J. van Bree,
Ellen M. W. van
der Meer,
Suzanne E. J. Kaal,
Jack Bennebroek-Gravenhorst,
Humphrey H. H. Kanhai,
Anneke Brand, and
Frans H. J. Claas
From the Departments of Obstetrics and of Immunohematology and Blood
Bank, Leiden University Medical Center, Leiden, and the Department of
Dermatology, University Hospital Nijmegen, Nijmegen, The Netherlands.
Persistence of donor leukocytes in the circulation of recipients of
intrauterine transfusion (IUT) has been observed up to 5 years after
birth. The aim of this study was to determine whether transfusions with
nonirradiated, nonleukocyte-depleted donor blood during the fetal
period resulted in long-term immunomodulation of the recipient.
Twenty-four surviving IUT recipients between 1966 and 1976 were tested
for autoimmune disease and autoantibodies at follow-up. Ten had
sex-mismatched donors and were therefore informative for chimerism
studies using fluorescence in situ hybridization (FISH). Seven female
recipients could be tested for chimerism using a
Y- chromosome-specific polymerase chain reaction (PCR) because they
received at least 1 IUT from a male donor. Nine recipients could be
studied for cytotoxic T-lymphocyte precursor (CTLp) and helper
T-lymphocyte precursor (HTLp) frequencies because the original donors
were available for testing. All surviving IUT recipients were in good
health at the time of the examination, and routine laboratory testing
revealed no abnormalities. None of the IUT recipients were chimeric as
determined by FISH analysis, but Y-chromosome-specific sequences were
detected by PCR in 6 of the 7 women. However, the CTLp and HTLp
frequencies of the IUT recipients against the donors were comparable to
those of the controls. The current study provides evidence
that IUT can result in the persistence of donor cells in the recipient
for a period longer than 20 years but that it is not associated with
immunotolerance or with signs of chronic antigenic stimulation.
