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Caughey MC, Francis RO, Karafin MS. New and emerging technologies for pretransfusion blood quality assessment: A state-of-the-art review. Transfusion 2024. [PMID: 39325509 DOI: 10.1111/trf.18019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 08/14/2024] [Accepted: 09/07/2024] [Indexed: 09/27/2024]
Affiliation(s)
- Melissa C Caughey
- Joint Department of Biomedical Engineering, University of North Carolina and North Carolina State University, Chapel Hill, North Carolina, USA
| | - Richard O Francis
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Matthew S Karafin
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
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2
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He L, Shao M, Yang X, Si L, Jiang M, Wang T, Ke Z, Peng T, Fang S, Zhang S, Ouyang X, Zhao G, Zhou J. Morphology Analysis of Unlabeled Red Blood Cells based on Quantitative Differential Phase Contrast Microscopy. Cytometry A 2022; 101:648-657. [PMID: 35243761 DOI: 10.1002/cyto.a.24546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/06/2022] [Accepted: 02/25/2022] [Indexed: 11/10/2022]
Abstract
The current classical blood smear technique to observe the morphology of single red blood cells (RBCs) for classification is a laborious and error-prone process. To objectively evaluate the morphology of blood cells, we established a method of computational imaging based on a programmable light emitting diode (LED) array. By using quantitative differential phase contrast (qDPC), we characterized the morphology of unlabeled RBCs as well as blood smears. By focusing on comparing the difference of imaging between unlabeled RBCs and stained RBCs under multi-mode microscopic imaging technology, we demonstrated that qDPC could clearly differentiate discocytes and spherocytes in both unlabeled RBCs and blood smears. The phase map provided by QPI further enhanced the classification accuracy. According to statistical analysis from morphological indexes, the qDPC imaging has a significantly improvement in non-circularity, texture inhomogeneity and equivalent diameters of cells. Thus, this method has a significant superiority in the capability to analyze the morphology of RBCs and could be applied to clinical assays for determining morphological, functional, and structural deterioration of RBCs.
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Affiliation(s)
- Linna He
- Anhui Medical University, Research and Engineering Center of Biomedical Materials, School of Biomedical Engineering, Hefei, Anhui, China
| | - Meng Shao
- Anhui Medical University, Research and Engineering Center of Biomedical Materials, School of Biomedical Engineering, Hefei, Anhui, China
| | - Xiao Yang
- Anhui Medical University, Research and Engineering Center of Biomedical Materials, School of Biomedical Engineering, Hefei, Anhui, China
| | - Li Si
- The first Affiliated Hospital of Anhui Medical University, Clinical Laboratory Department, Hefei, Anhui, China
| | - Mengduo Jiang
- Anhui Medical University, Research and Engineering Center of Biomedical Materials, School of Biomedical Engineering, Hefei, Anhui, China
| | - Tao Wang
- Anhui Medical University, Research and Engineering Center of Biomedical Materials, School of Biomedical Engineering, Hefei, Anhui, China
| | - Zeyu Ke
- Anhui Medical University, Research and Engineering Center of Biomedical Materials, School of Biomedical Engineering, Hefei, Anhui, China
| | - Tao Peng
- Anhui Medical University, Research and Engineering Center of Biomedical Materials, School of Biomedical Engineering, Hefei, Anhui, China
| | - Shu Fang
- Anhui Medical University, Research and Engineering Center of Biomedical Materials, School of Biomedical Engineering, Hefei, Anhui, China
| | - Shengzhao Zhang
- Anhui Medical University, Research and Engineering Center of Biomedical Materials, School of Biomedical Engineering, Hefei, Anhui, China
| | - Xilin Ouyang
- The Fourth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Gang Zhao
- University of Science and Technology of China, Department of Electronic Science and Technology, Hefei, Anhui, China
| | - Jinhua Zhou
- Anhui Medical University, Research and Engineering Center of Biomedical Materials, School of Biomedical Engineering, Hefei, Anhui, China
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Ameri Z, Farsinejad A, Vahidi R, Sheikh Rezaei
Z, Khaleghi M, Parvizi P, Moghadari M. Band 3 Protein: An Effective Interrogation Tool of Storage Lesions in RBC Units. Indian J Hematol Blood Transfus 2021; 38:373-380. [PMID: 35496977 PMCID: PMC9001803 DOI: 10.1007/s12288-021-01447-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 05/12/2021] [Indexed: 11/25/2022] Open
Abstract
The present study aims to investigate the changes in different parameters related to the storage time of red blood cell (RBC) units. Microscopic, flow cytometric, and electrophoretic assessments were employed every few days for 60 days to investigate the alterations in morphology, size, phosphatidylserine (PS) externalization, and membrane proteins over time. Morphological transformation from discocytes to spherocytes progressed as the storage time increased, which was accompanied by an increment of cellular size. However, this storage period did not result in the externalization of significant amounts of PS (p > 0.05). Mean Fluorescence Intensity (MFI) values increased by 11% to 23% between days 21 and 35 compared to the day 1 sample (p < 0.001). By day 60, the MFI decreased to about 70% of the day 1 sample. The analysis of membrane proteins' distribution showed a significant drop in band 3 expression after 35 days (p < 0.05 and 0.001 on days 42 and 60, respectively); however, no significant change was observed up to five weeks (p > 0.05). The inconsistency observed between Eosin-5-Maleimide (5-EMA) binding and the relative band 3 content could be due to additional accessibility of 5-EMA to hidden domains of other membrane proteins on RBCs as a result of increased mean corpuscular volume (MCV) and changes in morphology. Overall, our present study represents a step-wise and time-dependent series of events that progressively affects stored RBCs.
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Affiliation(s)
- Zahra Ameri
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
- Department of Tissue Engineering and Regenerative Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
- Cell Therapy and Regenerative Medicine Comprehensive Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Alireza Farsinejad
- Cell Therapy and Regenerative Medicine Comprehensive Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Hematology and Laboratory Sciences, Faculty of Allied Medical Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Vahidi
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - Zahra Sheikh Rezaei
- Department of Hematology and Laboratory Sciences, Faculty of Allied Medical Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Morteza Khaleghi
- Department of Clinical Biochemistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Poorya Parvizi
- Student Research Committee, Faculty of Allied Medical Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Masoud Moghadari
- Department of Traditional Medicine, Faculty of Traditional Medicine, Kerman University of Medical Sciences, Kerman, Iran
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4
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Melzak KA, Spouge JL, Boecker C, Kirschhöfer F, Brenner-Weiss G, Bieback K. Hemolysis Pathways during Storage of Erythrocytes and Inter-Donor Variability in Erythrocyte Morphology. Transfus Med Hemother 2021; 48:39-47. [PMID: 33708051 DOI: 10.1159/000508711] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/03/2020] [Indexed: 01/10/2023] Open
Abstract
Background Red blood cells (RBCs) stored for transfusions can lyse over the course of the storage period. The lysis is traditionally assumed to occur via the formation of spiculated echinocyte forms, so that cells that appear smoother are assumed to have better storage quality. We investigate this hypothesis by comparing the morphological distribution to the hemolysis for samples from different donors. Methods Red cell concentrates were obtained from a regional blood bank quality control laboratory. Out of 636 units processed by the laboratory, we obtained 26 high hemolysis units and 24 low hemolysis units for assessment of RBC morphology. The association between the morphology and the hemolysis was tested with the Wilcoxon-Mann-Whitney U test. Results Samples with high stomatocyte counts (p = 0.0012) were associated with increased hemolysis, implying that cells can lyse via the formation of stomatocytes. Conclusion RBCs can lyse without significant echinocyte formation. Lower degrees of spiculation are not a good indicator of low hemolysis when RBCs from different donors are compared.
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Affiliation(s)
- Kathryn A Melzak
- Institute of Functional Interfaces, Karlsruhe Institute of Technology, Eggenstein-Leopoldshafen, Germany
| | - John L Spouge
- National Center for Biotechnology Information, National Institutes of Health USA, Bethesda, Maryland, USA
| | - Clemens Boecker
- Institute of Functional Interfaces, Karlsruhe Institute of Technology, Eggenstein-Leopoldshafen, Germany
| | - Frank Kirschhöfer
- Institute of Functional Interfaces, Karlsruhe Institute of Technology, Eggenstein-Leopoldshafen, Germany
| | - Gerald Brenner-Weiss
- Institute of Functional Interfaces, Karlsruhe Institute of Technology, Eggenstein-Leopoldshafen, Germany
| | - Karen Bieback
- Institute for Transfusion Medicine and Immunology, Flowcore Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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5
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Modelling of Red Blood Cell Morphological and Deformability Changes during In-Vitro Storage. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10093209] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Storage lesion is a critical issue facing transfusion treatments, and it adversely affects the quality and viability of stored red blood cells (RBCs). RBC deformability is a key indicator of cell health. Deformability measurements of each RBC unit are a key challenge in transfusion medicine research and clinical haematology. In this paper, a numerical study, inspired from the previous research for RBC deformability and morphology predictions, is conducted for the first time, to investigate the deformability and morphology characteristics of RBCs undergoing storage lesion. This study investigates the evolution of the cell shape factor, elongation index and membrane spicule details, where applicable, of discocyte, echinocyte I, echinocyte II, echinocyte III and sphero-echinocyte morphologies during 42 days of in-vitro storage at 4 °C in saline-adenine-glucose-mannitol (SAGM). Computer simulations were performed to investigate the influence of storage lesion-induced membrane structural defects on cell deformability and its recoverability during optical tweezers stretching deformations. The predicted morphology and deformability indicate decreasing quality and viability of stored RBCs undergoing storage lesion. The loss of membrane structural integrity due to the storage lesion further degrades the cell deformability and recoverability during mechanical deformations. This numerical approach provides a potential framework to study the RBC deformation characteristics under varying pathophysiological conditions for better diagnostics and treatments.
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Pinto RN, Hysi E, Bagga K, Sebastian JA, Douplik A, Acker JP, Kolios MC. Feasibility of photoacoustic imaging for the non-invasive quality management of stored blood bags. Vox Sang 2019; 114:701-710. [PMID: 31392743 DOI: 10.1111/vox.12828] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/12/2019] [Accepted: 07/02/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVES During the in vitro storage of red blood cells (RBCs), unfavourable changes (storage lesions) cause a rapid consumption of intracellular diphosphoglycerate. The latter deregulates the oxygen-haemoglobin binding potential, subsequently increasing oxygen saturation (SO2 ) and membrane degradation, transforming RBCs from biconcave discs to rigid spherical bodies (spheroechinocytes). Current laboratory techniques invasively extract RBC samples to assess the quality of red cell concentrate (RCC) units. Optical technologies could provide a means of assessing quality non-invasively. MATERIALS AND METHODS A photoacoustic (PA) imaging technique was developed for acquiring the SO2 of blood bags non-invasively. Seven RCC units were monitored every 3-5 days until expiry (6 weeks). Measurements were validated against a conventional blood gas analyzer (BGA). Using an image flow cytometry assay, morphological profile trends were compared against the SO2 trends during blood bag storage. RESULTS A strong correlation (r2 ≥ 0·95) was found when comparing temporal data between PA and BGA SO2 measurements. Inter-sample PA variability was found to be similar to that produced by BGA (±0·8%). A strong correlation was found to exist between the temporal changes in SO2 and relative spheroechinocyte population (0·79 ≤ r2 ≤ 0·97). CONCLUSION This study suggests that PA imaging can non-invasively track the SO2 of stored RBCs non-invasively. By longitudinally monitoring the change in SO2 , it is possible to infer the effects of the storage lesion on RBC morphology. This non-invasive monitoring technique allows for the assessment of blood bags, without compromising sterility pre-transfusion.
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Affiliation(s)
- Ruben N Pinto
- Institute of Biomedical Engineering, Science and Technology, Toronto, ON, Canada.,Department of Physics, Ryerson University, Toronto, ON, Canada
| | - Eno Hysi
- Institute of Biomedical Engineering, Science and Technology, Toronto, ON, Canada.,Department of Physics, Ryerson University, Toronto, ON, Canada
| | - Karan Bagga
- Institute of Biomedical Engineering, Science and Technology, Toronto, ON, Canada.,Department of Mechanical & Industrial Engineering, Ryerson University, Toronto, ON, Canada
| | - Joseph A Sebastian
- Institute of Biomedical Engineering, Science and Technology, Toronto, ON, Canada.,Department of Electrical, Computer, and Biomedical Engineering, Ryerson University, Toronto, ON, Canada
| | - Alexandre Douplik
- Institute of Biomedical Engineering, Science and Technology, Toronto, ON, Canada.,Department of Physics, Ryerson University, Toronto, ON, Canada
| | - Jason P Acker
- Centre for Innovation, Canadian Blood Services, Edmonton, AB, Canada.,Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - Michael C Kolios
- Institute of Biomedical Engineering, Science and Technology, Toronto, ON, Canada.,Department of Physics, Ryerson University, Toronto, ON, Canada
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7
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Pinto RN, Sebastian JA, Parsons MJ, Chang TC, Turner TR, Acker JP, Kolios MC. Label‐Free Analysis of Red Blood Cell Storage Lesions Using Imaging Flow Cytometry. Cytometry A 2019; 95:976-984. [DOI: 10.1002/cyto.a.23846] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 06/12/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Ruben N. Pinto
- Institute of Biomedical Engineering Science and Technology (iBEST) Toronto Ontario M5B 1T8 Canada
- Department of PhysicsRyerson University Toronto Ontario M5B 2K3 Canada
| | - Joseph A. Sebastian
- Institute of Biomedical Engineering Science and Technology (iBEST) Toronto Ontario M5B 1T8 Canada
- Department of Electrical, Computer, and Biomedical EngineeringRyerson University Toronto Ontario M5B 2K3 Canada
| | - Michael J. Parsons
- Lunenfeld‐Tanenbaum Research Institute (LTRI)Sinai Health System Toronto Ontario M5G 1X5 Canada
| | - Tim C. Chang
- MilliporeSigma, a business of Merck KGaA Seattle Washington 98119
| | - Tracey R. Turner
- Centre for InnovationCanadian Blood Services Edmonton Alberta T6G 2R8 Canada
| | - Jason P. Acker
- Centre for InnovationCanadian Blood Services Edmonton Alberta T6G 2R8 Canada
- Department of Laboratory Medicine and PathologyUniversity of Alberta Edmonton Alberta T6G 2R8 Canada
| | - Michael C. Kolios
- Institute of Biomedical Engineering Science and Technology (iBEST) Toronto Ontario M5B 1T8 Canada
- Department of PhysicsRyerson University Toronto Ontario M5B 2K3 Canada
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8
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Garden OA, Kidd L, Mexas AM, Chang YM, Jeffery U, Blois SL, Fogle JE, MacNeill AL, Lubas G, Birkenheuer A, Buoncompagni S, Dandrieux JRS, Di Loria A, Fellman CL, Glanemann B, Goggs R, Granick JL, LeVine DN, Sharp CR, Smith-Carr S, Swann JW, Szladovits B. ACVIM consensus statement on the diagnosis of immune-mediated hemolytic anemia in dogs and cats. J Vet Intern Med 2019; 33:313-334. [PMID: 30806491 PMCID: PMC6430921 DOI: 10.1111/jvim.15441] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 01/18/2019] [Indexed: 12/21/2022] Open
Abstract
Immune-mediated hemolytic anemia (IMHA) is an important cause of morbidity and mortality in dogs. IMHA also occurs in cats, although less commonly. IMHA is considered secondary when it can be attributed to an underlying disease, and as primary (idiopathic) if no cause is found. Eliminating diseases that cause IMHA may attenuate or stop immune-mediated erythrocyte destruction, and adverse consequences of long-term immunosuppressive treatment can be avoided. Infections, cancer, drugs, vaccines, and inflammatory processes may be underlying causes of IMHA. Evidence for these comorbidities has not been systematically evaluated, rendering evidence-based decisions difficult. We identified and extracted data from studies published in the veterinary literature and developed a novel tool for evaluation of evidence quality, using it to assess study design, diagnostic criteria for IMHA, comorbidities, and causality. Succinct evidence summary statements were written, along with screening recommendations. Statements were refined by conducting 3 iterations of Delphi review with panel and task force members. Commentary was solicited from several professional bodies to maximize clinical applicability before the recommendations were submitted. The resulting document is intended to provide clinical guidelines for diagnosis of, and underlying disease screening for, IMHA in dogs and cats. These should be implemented with consideration of animal, owner, and geographical factors.
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Affiliation(s)
- Oliver A Garden
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Linda Kidd
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, California
| | - Angela M Mexas
- College of Veterinary Medicine, Midwestern University, Downers Grove, Illinois
| | - Yu-Mei Chang
- Royal Veterinary College, University of London, London, United Kingdom
| | - Unity Jeffery
- College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Shauna L Blois
- Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Jonathan E Fogle
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Amy L MacNeill
- College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - George Lubas
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Adam Birkenheuer
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Simona Buoncompagni
- Internal Medicine Service, Central Oklahoma Veterinary Specialists, Oklahoma City, Oklahoma
| | - Julien R S Dandrieux
- Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, University of Melbourne, Melbourne, Australia
| | - Antonio Di Loria
- Department of Veterinary Medicine and Animal Production, University of Napoli Federico II, Napoli, Italy
| | - Claire L Fellman
- Cummings School of Veterinary Medicine, Tufts University, Massachusetts
| | - Barbara Glanemann
- Royal Veterinary College, University of London, London, United Kingdom
| | - Robert Goggs
- College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - Jennifer L Granick
- College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota
| | - Dana N LeVine
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa
| | - Claire R Sharp
- College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch University, Perth, Australia
| | | | - James W Swann
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom
| | - Balazs Szladovits
- Royal Veterinary College, University of London, London, United Kingdom
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