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Garraud O, Chiaroni J. An overview of red blood cell and platelet alloimmunisation in transfusion. Transfus Clin Biol 2022; 29:297-306. [PMID: 35970488 DOI: 10.1016/j.tracli.2022.08.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Post-transfusion alloimmunisation is the main complication of all those observed after one or more transfusion episodes. Alloimmunisation is observed after the transfusion of red blood cell concentrates but also of platelet concentrates. Besides alloimmunisation due to antigens carried almost exclusively by red blood cells such as those of the Rhesus-Kell system, alloimmunisation often raises against HLA antigens; the main responsibility for that, apart from platelet transfusions, lies with residual leukocytes in the products transfused, hence the central importance of effective leukoreduction right from the blood product preparation stage. Alloimmunization is not restricted to transfusion, but it is also observed during pregnancies, carrying out microtransfusions of blood from the fetus immunizing the mother through the placenta (in a retrograde way). Preexisting maternal-fetal immunization can complicate a transfusion program and intensify the creation of alloantibodies in several blood and tissue group systems. The occurrence of autoantibodies, created by several pathogenic reasons, can also interfere with the propensity of certain recipients of blood components to produce alloantibodies. The genetic condition of individuals is in fact strongly linked to the ability or not to recognize antigenic variants foreign to their own biological program and mount an alloimmune response. Some hemoglobin diseases, in carriers of which transfusions can be iterative and lifelong, are complicated by frequent alloimmunizations and amplification of the complications of these alloimmunizations, imposing even stricter transfusion rules. This review details the mechanisms favoring the occurrence of alloimmunization and the immunological principles for the production of molecular and cellular tools for alloimmunization. It concludes with the main preventive measures available to limit the occurrence of these frequent complications of varying severity but sometimes severe.
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Affiliation(s)
- Olivier Garraud
- Sainbiose-Inserm_U1059, Faculty of Medicine, University of Saint-Etienne, Saint-Etienne, France.
| | - Jacques Chiaroni
- Etablissement Français du Sang Provence-Alpes-Côte d'Azur-Corse, 13005 Marseille, France; Biologie des Groupes Sanguins, EFS, CNRS, ADES, Aix Marseille University, 13005 Marseille, France
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Tissot JD, Danic B, Cabaud JJ, Garraud O. [Ethical issues in transfusion medicine]. Transfus Clin Biol 2016; 23:119-26. [PMID: 27443188 DOI: 10.1016/j.tracli.2016.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Ethics is on the cross road of off values that are present along the ways of transfusion medicine. This is an important tool to afford opinions as well as debates that always emerge when discussing transfusion medicine. The wording is particularly important; this was one among several others that characterized the soul of Jean-Jacques Lefrère when he opened the doors of the ethical issues of transfusion medicine.
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Affiliation(s)
- J-D Tissot
- Transfusion interrégionale, Croix-Rouge suisse, 1066 Épalinges, Suisse
| | - B Danic
- Établissement français du sang Bretagne, 35016 Rennes, France
| | - J-J Cabaud
- Institut national de la transfusion sanguine, Paris, France
| | - O Garraud
- Institut national de la transfusion sanguine, Paris, France; Université de Lyon/Saint-Étienne, faculté de médecine, 42023 Saint-Étienne cedex 02, France.
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3
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Garraud O, Danic B, Cartron JP, Chiaroni J, Clavier B, Cuneo B, Guimelchain-Bonnet M, Hermitte MA, Mackowiak S, Monsellier M, Moreau S, Papa K, Pelletier B, Pottier R, Praile R, Saillol A, Tissot JD, Vernant JP, Hervé C. [Voluntariness and blood donation: Proceedings of an ethics seminar held at the National Institute for Blood Transfusion]. Transfus Clin Biol 2016; 23:168-74. [PMID: 27424281 DOI: 10.1016/j.tracli.2016.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Voluntariness stands for one of the four pillars of ethics in blood donation; it is, however, more related to tradition than to legislation. Because it seems necessary to apply "marketing" techniques to blood collection in order to meet the needs in blood components, both in terms of quantity and quality, one wonders if this may be at the expense of this principle of voluntariness. This seminar-belonging actually to a series of seminars in Ethics in Transfusion Medicine-aimed at questioning the possible weakness of voluntariness in the field of blood donation. To achieve this goal, specialists of numerous disciplines in medical sciences, law and humanities gathered to discuss all related issues to voluntariness in blood donation.
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Affiliation(s)
- O Garraud
- Institut national de la transfusion sanguine, 75015 Paris, France; EA3064, faculté de médecine de Saint-Étienne, université de Lyon, 42023 Lyon cedex 2, France.
| | - B Danic
- Établissement français du sang, La Plaine Stade-de-France, 93218 Saint-Denis, France
| | - J-P Cartron
- Institut national de la transfusion sanguine, 75015 Paris, France
| | - J Chiaroni
- Établissement français du sang, La Plaine Stade-de-France, 93218 Saint-Denis, France; Aix Marseille université CNRS-EFS-ADES-UNMR7268, 13344 Marseille, France
| | - B Clavier
- Centre de transfusion sanguine des armées, 92140 Clamart, France
| | - B Cuneo
- Cabinet Cunéo & Associés, 75014 Paris, France
| | | | | | - S Mackowiak
- Ministère de la justice, 75001 Paris, France
| | - M Monsellier
- Union nationale don de sang La Poste-Orange, 75013 Paris, France
| | - S Moreau
- Hématologie clinique et thérapie cellulaire, CHU de Limoges, 87042 Limoges, France
| | - K Papa
- Établissement français du sang, La Plaine Stade-de-France, 93218 Saint-Denis, France
| | - B Pelletier
- Établissement français du sang, La Plaine Stade-de-France, 93218 Saint-Denis, France
| | - R Pottier
- EA4569, anthropologie, université Paris-Descartes, 75006 Paris, France
| | - R Praile
- Fédération nationale pour le don de sang bénévole, 75011 Paris, France
| | - A Saillol
- Aix Marseille université CNRS-EFS-ADES-UNMR7268, 13344 Marseille, France
| | - J-D Tissot
- Transfusion interrégionale CRS, site d'Épalinges, 1066 Épalinges, Suisse; UNIL, faculté de biologie et de médecine, 1011 Lausanne, Suisse
| | - J-P Vernant
- Institut national de la transfusion sanguine, 75015 Paris, France; Université Paris-Pierre-et-Marie-Curie, 75005 Paris, France
| | - C Hervé
- EA4569, laboratoire d'éthique médicale, université Paris-Descartes, 75006 Paris, France
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Garraud O, Hamzeh-Cognasse H, Laradi S, Pozzetto B, Cognasse F. Transfusion et inflammation : hier – aujourd’hui – demain. Transfus Clin Biol 2015; 22:168-77. [DOI: 10.1016/j.tracli.2015.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Indexed: 12/11/2022]
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