Long before the advent of the acquired immunodeficiency syndrome (AIDS), it was recognized that blood contained potent antigens and that individuals who received multiple blood products had alterations of the immune response affecting the cellular and humoral responses and antibody production.
Data were accumulated by multiple investigators of transplantation to show that the success or failure of bone marrow engraftment could be related to antigenic stimulation from transfusions. The best results occurred in those patients who received the least number of transfusions prior to transplant.1 A different pattern was found with renal transplants, where there was as much as a 20% improvement in the engraftment rate when recipients had the antigenic stimulation of greater than four transfusions prior to transplant.2
Coincident with the knowledge of these immune alterations in transfused patients was the formidable news that since the late 1970s, the donor blood supply had been contaminated with
Hilgartner MW. AIDS in the Transfused Patient. Am J Dis Child. 1987;141(2):194-198. doi:10.1001/archpedi.1987.04460020084032