Survival of donor cells 25 years after intrauterine transfusion

Persistence of donor leukocytes in the circulation of recipients of intraut erine transfusion (IUT) has been observed up to 5 years after birth. The ai m of this study was to determine whether transfusions with nonirradiated, n onleukocyte-depleted donor blood during the fetal period resulted in long-t erm immunomodulation of the recipient. Twenty-four surviving IUT recipients between 1966 and 1976 were tested for autoimmune disease and autoantibodie s at follow-up. Ten had sex-mismatched donors and were therefore informativ e for chimerism studies using fluorescence in situ hybridization (FISH), Se ven female recipients could be tested for chimerism using a Y-chromosome-sp ecific polymerase chain reaction (PCR) because they received at least 1 IUT from a male donor. Nine recipients could be studied for cytotoxic T-lympho cyte precursor (CTLp) and helper T-lymphocyte precursor (HTLp) frequencies because the original donors were available for testing. All surviving IUT r ecipients were in good health at the time of the examination, and routine l aboratory testing revealed no abnormalities. None of the IUT recipients wer e chimeric as determined by FISH analysis, but Y-chromosome-specific sequen ces were detected by PCR in 6 of the 7 women. However, the CTLp and HTLp fr equencies of the IUT recipients against the donors were comparable to those of the controls. The current study provides evidence that IUT can result i n 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 o f chronic antigenic stimulation. (Blood. 2000; 95:2709-2714) (C) 2000 by Th e American Society of Hematology.