AUTHOR=Jin Xin , Pirenne Jacques , Vos Robin , Hooft Charlotte , Kaes Janne , Van Slambrouck Jan , Kortleven Phéline , Vandervelde Christelle , Beeckmans Hanne , Kerckhof Pieterjan , Carlon Marianne S. , Van Raemdonck Dirk , Looney Mark R. , Vanaudenaerde Bart M. , Ceulemans Laurens J. TITLE=Donor-Specific Blood Transfusion in Lung Transplantation JOURNAL=Transplant International VOLUME=37 YEAR=2024 URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2024.12822 DOI=10.3389/ti.2024.12822 ISSN=1432-2277 ABSTRACT=

Lung transplantation is still hindered by a high rate of chronic rejection necessitating profound immunosuppression with its associated complications. Donor-specific blood transfusion is a pre-transplant strategy aimed at improving graft acceptance. In contrast with standard stored blood or donor-specific regulatory T cells transfusions, this approach utilizes fresh whole blood from the donor prior to allograft transplantation, encompassing all cell types and plasma. The precise mechanisms underlying donor-specific blood transfusion-induced tolerance remain incompletely understood. Associations with regulatory/helper T cells, modulation of mononuclear phagocytic cells or microchimerism have been suggested. While numerous (pre-)clinical studies have explored its application in solid organ transplants like liver, kidney, and intestine, limited attention has been given to the setting of lung transplantation. This comprehensive review summarizes existing knowledge on the mechanisms and outcomes of donor-specific blood transfusion in solid organ transplants both in preclinical and clinical settings. We also address the potential benefits and risks associated with donor-specific blood transfusion in the field of lung transplantation, offering insights into future research directions.