Effect of red cell transfusion on the host immune response in critically ill patients

In this thesis we investigated the effect of RBC transfusion on the host immune response. We conclude that RBC transfusions in critically ill patients are associated with an inflammatory and procoagulant host response. Activated neutrophils, monocytes, platelets and endothelium cells are likely to be involved in this complex response, which seems stronger when an inflammatory status is present in the recipient. We hypothesize that RBC derived EVs are potent mediators of the association between RBC transfusion and the host response. There are multiple opportunities for further improvement of clinical practice as well as of the RBC product, with the aim to reduce immune modulating effects of RBC transfusion.