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Medical Forum / General / General / January 2004Blood transfusion to increase T cells
Hi I have a simplistic theory, which is bound to be wrong for some reason, the question is why is it wrong. An HIV positive person with low T-cell count could in principle receive regular whole blood transfusions from people of matching blood group, thus increasing their T cell count repeatedly. Donated cells would be killed but that would take time to happen, and perhaps enough blood could be transfused to keep someone at a livable count indefinitely (totally vague guess cell count 200). Ignore for the moment the question of blood supply: I'll address that if theres a reason to later. Since this is not widely practiced there must be a good reason why, but I dont know what it is. Could someone enlighten me? I'm trying to learn this subject as much as poss. Thanks, NT >I have a simplistic theory, which is bound to be wrong for some >reason, the question is why is it wrong. [quoted text clipped - 12 lines] >but I dont know what it is. Could someone enlighten me? I'm trying to >learn this subject as much as poss. One very simple reason: Graft-versus-host disease. Other people's white blood cell counts will look at your entire body as foreign and attack all organ systems. PF > >I have a simplistic theory, which is bound to be wrong for some > >reason, the question is why is it wrong. [quoted text clipped - 12 lines] > >but I dont know what it is. Could someone enlighten me? I'm trying to > >learn this subject as much as poss. > One very simple reason: Graft-versus-host disease. Other people's > white blood cell counts will look at your entire body as foreign and > attack all organ systems. > > PF So presumably a one off transfusion will not do enough damage to be noticed, but repeated ones will? I ask because way back when it was known you could transfuse whole blood without problems. Would the cells of close relatives attack like this too? Patients are given immunosuppressants after transplants, do these knock the cells right out or are they still able to do at least something, but not attack the host? Thanks, NT >> One very simple reason: Graft-versus-host disease. Other people's >> white blood cell counts will look at your entire body as foreign and [quoted text clipped - 3 lines] >noticed, but repeated ones will? I ask because way back when it was >known you could transfuse whole blood without problems. Yes, a transfusion including white cells (as in unfiltered packed red cells or whole blood) will likely not be a problem in a person with a normal immune system, as your own white cells will destroy the foreign ones. But cancer patients who are on immune suppressing drugs typically get transfusions that have had the white cells filtered out because they are more dangerous. >Would the cells of close relatives attack like this too? Probably. It's not just a matter of getting blood types or HLA types to match. The recognition by the immune system of self vs. non-self is probably very complex. PF > >> One very simple reason: Graft-versus-host disease. Other people's > >> white blood cell counts will look at your entire body as foreign and [quoted text clipped - 18 lines] > > PF Thank you. One last question: you say probably, does that mean theres any possibility it might not? Thanks, NT >> Probably. It's not just a matter of getting blood types or HLA types >> to match. The recognition by the immune system of self vs. non-self is >> probably very complex. > >Thank you. One last question: you say probably, does that mean theres >any possibility it might not? I'm not sure. I would guess that with a chronic transfusion program for an HIV patient as you suggest, it's bound to happen. PF > Hi > [quoted text clipped - 16 lines] > > Thanks, NT My theory, based purely on my experience in logical reasoning, NOT as an MD, is that whatever mechanism is causing the low T-count, would logically attack the infused cells. Likely before any they could do any good at all. > My theory, based purely on my experience in logical reasoning, NOT as an > MD, is that whatever mechanism is causing the low T-count, would > logically attack the infused cells. Yup, that I think is inevitable. > Likely before any they could do any > good at all. Why do you think that? A human has a limited output rate of new white cells, and if they have say a 200 count it must take time for the cells to die, it isnt instant. Do you think as things get advanced, and cell count very low, that the cells are being killed off virtually as soon as theyre produced? Would make sense. Regards, NT |
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