Background and Objectives: The beneficial effect of blood transfusion on kidney graft survival requires the presence of leukocytes in the transfusate, but a minimal dose has not been defined, nor has the role of individual leukocyte subsets been investigated. In the Netherlands, a standard pre-transplant blood transfusion consists of a buffy coat (BC)-depleted red blood cell concentrate (RBCC) containing a maximum of 1.2×109 residual leukocytes per unit. However, leukocyte subset composition is not standardized. Materials and Methods: Using FACS analysis, this study compared the residual leukocyte composition of RBCCs produced by Compomat® and Optipress®, two currently used top-bottom systems. Results: While the total leukocyte content of the RBCCs was equivalent in both press types (0.5×109), the percentage of mononuclear cells (lymphocytes and monocytes) was significantly higher in the Compomat as compared with the Optipress system (p < 0.0001), resulting in significantly higher numbers of transfused T cells, B cells, HLA-DR-positive cells, NK cells and stem cells. Conclusions: The leukocyte composition of a pre-transplant blood transfusion depends on the BC depletion method used; this might differentially affect the tolerizing or immunizing potential of a pre-transplant blood transfusion.

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