Differences in blood composition between deceased and living donors: Could it affect crossmatches?

• Published in: Human immunology Vol. 76; p. 90
• Main Authors: Lacelle, Chantale, Cameron, Amanda
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.10.2015
• Subjects: Allergy and Immunology
• ISSN: 0198-8859; 1879-1166
• DOI: 10.1016/j.humimm.2015.07.127

Until recently, most deceased donor crossmatches performed in our laboratory used cells isolated from node or spleen. However, due to changes at the OPO level it has become difficult to obtained pre-harvest node for crossmatches and donor blood is now routinely used. Since donors often receive blood transfusions and drugs in an attempt to save their lives, the effect of these factors on blood composition needs to be evaluated. We analyzed blood samples collected from deceased and living donors for white blood cell count (WBC) and percentage of lymphocytes, monocytes, and granulocytes using the COULTER® ACT diff2™ Analyzer. We found that deceased donors had a markedly different blood composition than living donors. The WBC count of deceased donor (14.2 × 103 cells/ μ L) was statistically higher than that of living donor (6.58 × 103 cells/ μ L, p < 0.05). Further, deceased donors had a significantly lower percentage of lymphocytes (13.1% vs 25.3%) and higher percentage of granulocytes (81.8% vs 66.7%) in their blood than living donors. No statistical difference was found in the percentage of monocytes. The observed differences in blood composition resulted in changes in cell preparation when the samples were separated using Ficoll. After Ficoll separation, cell preparations obtained from the blood of deceased donors had an average composition of 34.8% lymphocytes, 16.4% monocytes and 48.7% granulocytes, while cell preparations from living donors had an average of 82.8% lymphocytes, 9.3% monocytes and 7.8% granulocytes. The changes in percentage of lymphocytes and granulocytes were statistically significant ( p < 0.05 ). Our data indicates that blood composition varies between deceased and living donors and that Ficoll alone may not be an optimal isolation method for deceased donor blood. An excessive amount of granulocytes in cell preparations may affect crossmatch results as the expression of HLA may differ between lymphocytes and granulocytes. Additionally, this raises the questions as to whether the factors influencing the blood compartment of deceased donors also affect the expression of HLA class I and II on lymphocytes. Further studies will be needed to address whether the expression of HLA class I and II on lymphocytes isolated from decease donors differs from that of lymphocytes isolated from living donors.