The analysis of IgG, IgA and IgE serum immunoglobulins in 94 cardiac surgery patients, who received massive blood transfusions during the bypass procedure, has shown a selective increase in immunoglobulin levels, a fortnight after the operation. For 85% of patients,IgE levels increased usually independently of IgA but in close correlation with IgM variations. IgG levels were not altered. 2 weeks following surgery, IgE concentrations were found, on average, to have doubled and in several sera reached five times the initial level. These modifications were early and transient. The concentrations of serum IgE and IgM returned to pretransfusion levels within 2 months of surgery. For 44% of the total population,serum IgE could partly be absorbed onto pooled platelets or polymerized immunoglobulins. This finding suggests the formation of IgE type antibodies directed against white cell or immunoglobulin antigens following blood transfusions. No significant variations in IgE levels were observed after absorptions onto red blood cells (RBC). Such modifications of IgE concentration in cardiac surgery patients were not related to the disease and seemed to occur as a primary immune response following blood transfusions. In another study of 44 blood donors, who were immunized with washed red blood cells for test sera production, only 3 showed significant transient variations in serum IgE levels. Thus, RBC antigens do not appear to be frequently involved in such IgE responses.

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