Analysis of immune status of hemodialyzed adults: Association with prior transfusions

Peripheral blood leukocytes of 29 hemodialyzed adults, 19 transfused and 10 nontransfused, were studied using immunofluorescent staining with monoclonal antibodies and in vitro measurement of natural killer (NK) cell activity. When compared with control subjects, the absolute number of leukocytes in transfused hemodialyzed patients was significantly reduced (P < 0.01), as were the absolute numbers of OKT11⁺ cells (P < 0.01), and OKT4⁺ cells (P < 0.0001). The percent representation of OKT11⁺ and OKT4⁺ cells was also significantly lower among transfused hemodialyzed patients (P < 0.01 and 0.001 respectively), and this loss of OKT4⁺ cells resulted in a decrease in the ratio of OKT4⁺/OKT8⁺ cells (P < 0.01). The absolute number of Leu-7⁺ cells was also decreased in the transfused group (P < 0.05). A decrease in in vitro NK cell activity was present in both transfused and nontransfused hemodialyzed subjects. Whether these differences in peripheral blood lymphocytes were induced by the erythrocyte transfusions could not be determined; however, if they reflect changes in central lymphoid tissues, then these results may help explain the prolonged survival of renal allografts in transfused individuals.