Abstract
In 15 of 17 patients who received fresh or stored blood as whole blood or packed cells, a fivefold or greater rise in atypical lymphocytes or in vitro 3H-thymidine incorporation by blood leukocytes (or both) occurred one week after transfusion. These values declined to pretransfusion levels by the third week. The mean leukocyte 3H-thymidine incorporation at one week in these 17 patients (1067 disintegrations per second) was significantly greater than that found in five patients undergoing surgery without transfusion (423 disintegrations per second) or with an autotransfusion (457 disintegrations per second), or in three patients receiving frozen-thawed, leukocyte-depleted blood (163 disintegrations per second). Lymphocytotoxic reactivity was also detected in the serum of six of 12 patients. The frequency and timing of this cellular activation and its absence after administration of leukocyte-depleted blood favor an immunologic response to HL-A antigens on the transfused leukocytes and platelets as an explanation for this phenomenon.
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