Transfusion-related immunomodulation (TRIM) refers to the impact of a blood transfusion on the recipient's immune system. The pathogenesis of TRIM and possible effects seem unclear.
Purported effects:
(1) immunosuppressive effect (as initially described in renal transplant recipients)
(2) proinflammatory effect
(3) graft versus host disease (GVHD)
These are distinct from transfusion-transmitted infection, hemolytic transfusion reaction and allergic response. It is also important to exclude comorbid conditions, which are common in a person who is transfused.
Possible mediators of TRIM include:
(1) transfused mononuclear cells
(2) WBC-derived soluble mediators
(3) soluble HLA peptides
(4) storage-induce by-products from red blood cells (bioactive lipids, etc)
(5) platelet-derived factors
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