Transfusions of leukocyte-rich erythrocyte concentrates: a successful treatment in selected cases of habitual abortion.

Forty-nine women who suffered recurrent spontaneous abortion of unknown etiology were studied for cellular reactivity and blocking antibody in one-way mixed lymphocyte culture before and after their receipt of three transfusions of leukocyte-rich erythrocyte concentrates from third-party donors. Those 38 of the 49 women who had no blocking antibody all developed significant blocking activity after the transfusion series. Twenty-five of them have become pregnant since, and only one aborted again. The blocking activity demonstrable in 11 of 49 women was increased after the transfusions. Subsequently five of them became pregnant, and all aborted again. We later found that these five women, who considered themselves to be in perfect health, all had serologic signs of autoimmune disease. We advise against transfusion treatment of women who habitually abort without preceding immunologic investigation, because a population of habitual aborters may contain women with yet undiagnosed autoimmune disease, who would be worse off after blood transfusion. We conclude from our results that a selected population of habitual aborters, that is, those without blocking antibody, benefits from transfusion treatment.