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Adane T, Enawgaw B. Human leukocyte antigen alloimmunization prevention mechanisms in blood transfusion. Asian J Transfus Sci 2023; 17:264-272. [PMID: 38274979 PMCID: PMC10807525 DOI: 10.4103/ajts.ajts_144_21] [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: 09/23/2021] [Revised: 11/01/2021] [Accepted: 12/05/2021] [Indexed: 11/04/2022] Open
Abstract
In many fields of clinical medicine and blood transfusion, the human leukocyte antigen (HLA) system is crucial. Alloimmunization happens as a result of an immune response to foreign antigens encountered during blood transfusion. This gives rise to alloantibodies against red blood cells (RBCs), HLA, or human platelet antigen (HPA). HLA alloimmunization following allogeneic transfusion was shown to be a result of contaminating white blood cells (WBCs) present in the product. It is a common complication of transfusion therapy that leads to difficulties in clinical intolerance and refractoriness to platelet transfusion during patient management. Single-donor platelets, prophylactic HLA matching, leukoreduction, and irradiation of cellular blood products are some of the mechanisms to prevent HLA alloimmunization during a blood transfusion. Now, the best approach to reduce the occurrence of primary HLA alloimmunization is the removal of WBCs from the blood by filtration.
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Affiliation(s)
- Tiruneh Adane
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bamlaku Enawgaw
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Malati ZA, Pourfathollah AA, Dabbaghi R, Balagholi S, Javan MR. Evaluation of a New Method of Leukocyte Extractions from the Leukoreduction Filter. Indian J Hematol Blood Transfus 2023; 39:478-486. [PMID: 37304478 PMCID: PMC10247650 DOI: 10.1007/s12288-022-01618-x] [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: 12/04/2021] [Accepted: 12/19/2022] [Indexed: 01/15/2023] Open
Abstract
This study's purpose was to optimize the leukocyte extraction protocol and evaluate the efficacy of this new protocol. 12BioR blood filters were collected from Tehran Blood Transfusion Center. A twosyringe system and Multi-step rinsing were designed for cell extraction. The final purpose of this optimization was: (1) removed the residual RBCs, (2) reversed the leukocyte trapping process, and (3) remove the microparticles to obtain the high yield of target cells. Finally, Extracted cells were evaluated by Automated Cell count; Samples smear differential cell count, Trypan blue, and Annexin-PI staining. The results showed that on average 11.88 × 108 ± 3.32 leukocytes recovered after indirect washing and that the mean count of granulocytes, lymphocytes, and Monocyte in this sample was 5.24 ± 2.18 × 108, 5.57 ± 1.74 × 108, and 0.56 ± 0.38 × 108 respectively. Also, the mean percent of manual differential cell count after concentration was 42.81%, 41.80%, and 15.82% for granulocytes, lymphocytes, and monocytes respectively. Moreover, viability and apoptosis assay showed > 95% viability in mononuclear cells recovered from LRFs. It is concluded that the use of a double-syringe system and RBC and microparticles removal from leukoreduction filters lead to acceptable viable leukocyte count that can be used in in vitro and in vivo studies.
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Affiliation(s)
- Zahra Abbasi Malati
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Ali Akbar Pourfathollah
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
- Immunology Department Faculty Medical Science, Tarbiat Modares University, Tehran, Iran
| | - Rasul Dabbaghi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahar Balagholi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Javan
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
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Javan MR, Kafi-Abad SA, Zarif MN, Balagholi S, Dabbaghi R, Karami S. In-line Leukoreduction Filters; a New Source of Microparticle for Human and Animal Study. Transfus Apher Sci 2022; 62:103602. [PMID: 36396538 DOI: 10.1016/j.transci.2022.103602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 09/22/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The isolation of microparticles (MPs) from leukoreduction filters (LRFs) during cell extraction process introduced LRFs as a precious source of MPs for animal and human study. METHOD LRFs were collected from Tehran Blood Transfusion Center. The back-flushing method was used for leukocyte extraction from the LRFs. MPs were isolated through double-step centrifugation. Dynamic light scattering (DLS), electron microscopy (EM), and flow cytometry were performed for the evaluation of MPs size, morphology, and structural properties respectively. Statistical analyses were carried out to evaluation of differences between test and control groups. a p-value less than 0.05 indicates significant differences. RESULT DLS analysis showed that the average MP size in the test and control groups was 654.83 nm and 233.68 nm respectively. SEM images showed the spherical, oval, cell fragment, and micro-aggregate particles and TEM images demonstrated the mitochondrial-like body in the MPs. Flow cytometry studies also showed a significant increase in the percent of CD41, and CD14, and a significant decrease in the percent of CD235a in the test group compared to control (P value=0.029, P value=0.035, P value= 0.001 respectively). Moreover, the percentage of CD34 MPs indicated a borderline difference between the two groups (P value= 0.075). Finally count of MPs in the test and control groups was 1202095.34 and 280948.64, respectively and the difference was significant (P value=0.008). CONCLUSION It is concluded that LRFs are a potential source of the large volume of various cell MPs with different phenotypical and structural properties for animal and human phase studies. Moreover, the investigation of LRFs as a source of different types of exosomes can shed new light on extracellular vesicle studies.
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Hopkins CK, Townsend M, Vassallo RR. Leukoreduction filters: Still stuck on sickle trait red cells. Transfusion 2022; 62:1683-1687. [PMID: 36039825 DOI: 10.1111/trf.17077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 11/29/2022]
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Fabrication of a new all-in-one microfluidic dielectrophoresis integrated chip and living cell separation. iScience 2022; 25:103776. [PMID: 35146391 PMCID: PMC8819401 DOI: 10.1016/j.isci.2022.103776] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/16/2021] [Accepted: 01/11/2022] [Indexed: 11/22/2022] Open
Abstract
Microfluidic dielectrophoresis (DEP) technology has been applied to many devices to perform label-free target cell separation. Cells separated by these devices are used in laboratories, mainly for medical research. The present study designed a microfluidic DEP device to fabricate a rapid and semiautomated cell separation system in conjunction with microscopy to enumerate the separated cells. With this device, we efficiently segregated bacterial cells from liquid products and enriched one cell type from two mixed eukaryotic cell types. The device eliminated sample pretreatment and established cell separation by all-in-one operation in a lab-on-chip, requiring only a small sample volume (0.5–1 mL) to enumerate the target cells and completing the entire separation process within 30 min. Such a rapid cell separation technique is in high demand by many researchers to promptly characterize the target cells. A new all-in-one microfluidic dielectrophoresis integrated chip is fabricated Simultaneous operation of buffer exchange and continuous cell separation on a chip Chip’s cell separation performance is evaluated with bacterial and eukaryotic cells
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Urias EVR, Teles LDF, Lula JF, Rocha CU, Pereira IA, Givisiez FN, Viana AG, Soares TDCM, Carvalho SFG. Leukocyte filters: a review of the mechanisms and applications in hemotherapy. Rev Assoc Med Bras (1992) 2021; 67:1056-1060. [DOI: 10.1590/1806-9282.20210383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/28/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
- Elaine Veloso Rocha Urias
- Fundação Centro de Hematologia e Hemoterapia de Minas Gerais, Brazil; Universidade Estadual de Montes Claros, Brazil; Faculdades Integradas Pitágoras, Brazil
| | - Leandro de Freitas Teles
- Fundação Centro de Hematologia e Hemoterapia de Minas Gerais, Brazil; Universidade Estadual de Montes Claros, Brazil
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Mittal S, Chacko MP, Varughese S, Raj A, Gowri M, Thankachen R, Mammen J, Daniel D. Laboratory and clinical comparison of the efficacy of prestorage leukoreduction of red cells at cold versus room temperature. Transfusion 2021; 61:2556-2565. [PMID: 34169541 DOI: 10.1111/trf.16570] [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: 08/18/2020] [Revised: 05/20/2021] [Accepted: 05/20/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND The temperature at which filtration takes place has been reported to influence the efficacy of leukoreduction. We aimed to compare the residual leukocyte count (RLC) in red cell units (RCUs) filtered at cold (CT) versus room temperature (RT) and to assess whether this correlates clinically with a difference in the incidence of acute transfusion reactions (ATRs). METHODS AND MATERIALS In the first part of the study, whole blood units collected were randomly allocated for subsequent filtration at CT and RT, respectively. RLC postfiltration was assessed using flow cytometry. The second part of the study was a nonrandomized clinical trial in which incidence of ATR was compared between RCUs filtered at RT and CT for 6 months each. RESULTS Thirty-five RCUs each underwent leukofiltration at CT and RT, respectively. The median RLCs in the filtered units at CT and RT were 0.02 × 106 and 0.1 × 106 leukocytes/unit, respectively (p = .0001), with no difference in red blood cell (RBC) recovery (p = .41). During the second part, 3455 RCUs filtered at RT and 3539 RCUs filtered at CT were transfused to patients. The rate of febrile non-hemolytic transfusion reaction (FNHTR) among transfused patients was less with units filtered at CT (1 per 2000 transfusions) in comparison to RT (1 per 588 transfusions). The difference was, however, not significant (p = .14). CONCLUSION If change in temperature alone can cause significant reduction in leukocytes, then it is a simple way to curtail the rate of this common yet unpleasant reaction and reduce the reaction rate at minimal cost.
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Affiliation(s)
- Siddharth Mittal
- Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, India
| | - Mary Purna Chacko
- Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, India
| | | | - Amal Raj
- Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, India
| | - Mahasampath Gowri
- Department of Biostatistics, Christian Medical College, Vellore, India
| | - Roy Thankachen
- Department of Cardio Thoracic Surgery, Christian Medical College, Vellore, India
| | - Joy Mammen
- Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, India
| | - Dolly Daniel
- Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, India
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Bashiri Dezfouli A, Pourfathollah AA, Nikougoftar-Zarif M, Khosravi M, Tajrishi M, Ezzati N, Kashani Khatib Z, Abbasi Sourki P, Valizadeh M. Optimizing the recovery of peripheral blood mononuclear cells trapped in leukoreduction filters - A comparison study. Hematol Transfus Cell Ther 2020; 44:197-205. [PMID: 33423981 PMCID: PMC9123569 DOI: 10.1016/j.htct.2020.09.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 07/26/2020] [Accepted: 09/19/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction The isolation of captured peripheral blood mononuclear cells (PBMNCs) from leukoreduction filters (LRFs) can be of great importance in terms of bringing the lost cells back into use. Objective The aim of this study was to evaluate various methods based on their potential to recover the peripheral blood cells from LRFs with a focus on mononuclear cells (MNCs). Method For cell isolation from LRFs, three distinct methods (back-flushing, direct and vacuum pump) were compared through the calculation of the yield of isolated MNCs. The viability of extracted cells was determined by the flow cytometry technique. Moreover, the recovered MNCs were characterized regarding the presence of blood stem cell purification. The cell culture, microscopic observation, and immunophenotyping were employed to characterize the blood stem cells (hematopoietic, mesenchymal and progenitor endothelial stem cells). Results The yield of isolation obtained in the back-flushing, direct and vacuum pump methods were 17.7 ± 1.28, 17.3 ± 0.96 and 21.2 ± 0.90 percent, respectively. Although the highest potential for total blood cell recovery belonged to the vacuum pump method, the lowest cell viability (85.73 ± 4.84%) was observed in this method. However, the isolation process of the back-flushing and direct methods had less effect on cell viability. The characterization of the isolated MNCs displayed that the dominant positive phenotype was for CD34/CD45, indicating hematopoietic stem cells. In addition, the endothelial stem/progenitor cells were significantly detected as CD31/CD133 positive cells. Conclusion According to our results and considering the safety and efficiency potential of each of the applied methods, the back-flushing in comparison with the other methods can be considered a suitable procedure for MNC isolation from LRFs.
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Affiliation(s)
- Ali Bashiri Dezfouli
- Tarbiat Modares University, Faculty of Medical Science, Tehran, Iran
- Iranian Blood Transfusion Organization, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
- Corresponding author at: Department of Immunology, Tarbiat Modarres University, P.O. Box. 14115-331 Tehran, Iran.
| | - Ali Akbar Pourfathollah
- Tarbiat Modares University, Faculty of Medical Science, Tehran, Iran
- Iranian Blood Transfusion Organization, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
- Corresponding author at: Department of Immunology, Tarbiat Modarres University, P.O. Box. 14115-331 Tehran, Iran.
| | - Mahin Nikougoftar-Zarif
- Iranian Blood Transfusion Organization, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Mohammad Khosravi
- Shahid Chamran University of Ahvaz, Faculty of Veterinary Medicine, Ahvaz, Iran
| | - Mona Tajrishi
- Iranian Blood Transfusion Organization, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Nasim Ezzati
- Iranian Blood Transfusion Organization, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Zahra Kashani Khatib
- Iranian Blood Transfusion Organization, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | | | - Maryam Valizadeh
- Tarbiat Modares University, Faculty of Medical Science, Tehran, Iran
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Pandey P, Pande A, Setya D, Kumar P, Shanker A. Comparative Study for Measurement of Residual Leucocytes in Leucodepleted Red Blood Cells by Two Different Methods. Indian J Hematol Blood Transfus 2020; 36:740-744. [PMID: 33100719 DOI: 10.1007/s12288-020-01325-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/20/2020] [Indexed: 11/25/2022] Open
Abstract
Estimation of residual leukocytes in blood components after leukodepletion is crucial for assessment of quality. Flow cytometry (FC) and Nageotte hemocytometer are the most widely accepted methods for counting residual white blood cells (rWBCs) in leucocyte-depleted (LD) blood components. The objective of this study was to compare use of Nageotte counting chamber and FC for quality control of leukodepleted red cell units. A prospective, observational study was conducted in the department of Transfusion Medicine. A total of 80 whole blood donations from healthy donors were subjected to testing by FC and Nageotte hemocytometer for estimation of rWBC in duplicate. Additionally, ten personnel attempted a survey for ease of use of FC. Number of rWBC detected by flow cytometer were between 1 WBC/μL and 28 WBCs/μL whereas that detected by Nageotte's chamber were between 0 WBC/μL (lowest) and 5 WBCs/μL. Coefficient of variation was found to be 87.36% by Nageotte hemocytometer method and 43.26% by FC. Linear regression analysis did not show any correlation (R-squared = 0.01, p = 0.13) between the two methods which signifies that the two methods cannot be used interchangeably. Pearson's correlation coefficient showed a weak relation between results obtained by the two methods. Inter-observer variation was found to be significant with use of Nageotte hemocytometry. Survey for ease of use of FC indicated acceptability of FC with favorable scores. Flow cytometric technique provides a reproducible and objective tool for counting rWBC in leukodepleted blood components compared with the Nageotte hemocytometer.
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Affiliation(s)
- Prashant Pandey
- Department of Transfusion Medicine, Histocompatibility and Molecular Biology, Jaypee Hospital, Sector-128, Noida, 201304 India
| | - Amit Pande
- Department of Transfusion Medicine, Histocompatibility and Molecular Biology, Jaypee Hospital, Sector-128, Noida, 201304 India
| | - Divya Setya
- Department of Transfusion Medicine, Histocompatibility and Molecular Biology, Jaypee Hospital, Sector-128, Noida, 201304 India
| | - Praveen Kumar
- Department of Transfusion Medicine, Histocompatibility and Molecular Biology, Jaypee Hospital, Sector-128, Noida, 201304 India
| | - Ajay Shanker
- Department of Transfusion Medicine, Histocompatibility and Molecular Biology, Jaypee Hospital, Sector-128, Noida, 201304 India
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McQuinn ER, Smith SA, Viall AK, Wang C, LeVine DN. Neutrophil extracellular traps in stored canine red blood cell units. J Vet Intern Med 2020; 34:1894-1902. [PMID: 32881076 PMCID: PMC7517510 DOI: 10.1111/jvim.15876] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 07/18/2020] [Accepted: 08/05/2020] [Indexed: 12/21/2022] Open
Abstract
Background Neutrophil extracellular traps (NETs), webs of DNA and citrullinated histones extruded from activated neutrophils cause transfusion‐related acute lung injury. Supernatants of stored red blood cell (RBC) units might promote NETosis in neutrophils from the units or from transfusion recipients. Hypotheses (1) NETs form during storage of canine RBC, (2) leukoreduction (LR) before storage of RBC reduces NETosis, and (3) supernatant from stored, nonleukoreduced (NLR) RBC units induces NETosis in healthy canine neutrophils modeling transfusion recipients. Animals Six healthy purpose‐bred research dogs were utilized for blood donation. Methods Prospective controlled study. RBC units were collected from each dog, aseptically divided into 2 equal subunits, 1 of which was leukoreduced, and stored for 42 days. Stored units were sampled biweekly for quantification of NET markers citrullinated histone H3 (Western blot) and cell‐free DNA (cfDNA) (DNA dye binding). Unit supernatants were applied ex vivo to canine neutrophils and extracellular DNA release representing NETosis was assessed. Results Markers of NETs increased during RBC storage (cfDNA P < .0001 and citrullinated H3 P = .0002) and were higher in NLR than LR units (day 42 LR cfDNA 0.34 ± 0.82 ng/mL vs day 42 NLR 1361.07 ± 741.00 ng/mL, P < .0001; day 42 LR citrullinated H3 0.19 ± 0.13 AU vs NLR 0.57 ± 0.34 AU, P = .007). Isolated neutrophils did not form NETs when exposed to stored canine RBC supernatant. Conclusions and Clinical Importance NETosis occurs in stored canine NLR RBC units, and is attenuated by LR before storage. NETs might be mediators of transfusion reactions.
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Affiliation(s)
- Erin R McQuinn
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, Iowa, USA
| | - Stephanie A Smith
- Department of Biochemistry, College of Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Austin K Viall
- Department of Veterinary Pathology, Iowa State University, Ames, Iowa, USA
| | - Chong Wang
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, Iowa, USA
| | - Dana N LeVine
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, Iowa, USA
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Shindo Y, Mitsuyama K, Yamasaki H, Imai T, Yoshioka S, Kuwaki K, Yamauchi R, Yoshimura T, Araki T, Morita M, Tsuruta K, Yamasaki S, Fukami K, Torimura T. Safety and efficacy of single-needle leukocyte apheresis for treatment of ulcerative colitis. Ther Apher Dial 2020; 24:503-510. [PMID: 32526089 DOI: 10.1111/1744-9987.13539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Leukocyte apheresis (LCAP) is a safe and effective treatment for active ulcerative colitis (UC) in Japan. Nevertheless, a limitation of LCAP is its requirement for two puncture sites (double-needle [DN] apheresis), sometimes leading to problems with needle puncture. Single-needle (SN) apheresis is useful in hemodialysis and reduces needle puncture pain. If SN apheresis were found to be useful in LCAP for UC, it may reduce patient burden. The aim of this study was to compare the safety and efficacy of SN apheresis with that of DN apheresis. Twenty-four patients with active UC were retrospectively enrolled. They underwent either SN apheresis (n = 12) or conventional double-needle (DN) apheresis (n = 12) at the Kurume University Hospital from February 2014 to March 2018. At each session, we recorded access problems defined by the time required to initiate apheresis and the frequency of puncture-related problems, as well as blood circuit clotting, defined as clotting necessitating interruption of apheresis and changing of the circuit. Efficacy was assessed using partial Mayo scores. The number of apheresis sessions was comparable between SN and DN apheresis (9.0 ± 2.0 times vs 9.6 ± 1.4 times, mean ± SEM). SN significantly reduced the time required to start apheresis (10.0 ± 5.4 minutes vs 19.4 ± 11.9 minutes, P < .05) as well as needle puncture troubles (0.9% vs 11.5%, P < .05). SN had comparable frequency of blood clotting episodes (5.6% vs 8.7%). SN apheresis had similar clinical efficacy (P < .001 in SN and P < .01 in DN). The improvement and remission rates were comparable between groups. SN apheresis may be safe and effective and may reduce patient burden during UC treatment. Nevertheless, further comparative studies are needed.
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Affiliation(s)
- Yoichiro Shindo
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Keiichi Mitsuyama
- Inflammatory Bowel Disease Center, Kurume University School of Medicine, Kurume, Japan
| | - Hiroshi Yamasaki
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.,Inflammatory Bowel Disease Center, Kurume University School of Medicine, Kurume, Japan.,Hakuai Hospital, Kurume, Japan
| | - Tetsuro Imai
- Clinical Engineering Center, Kurume University Hospital, Kurume, Japan
| | - Shinichiro Yoshioka
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.,Inflammatory Bowel Disease Center, Kurume University School of Medicine, Kurume, Japan
| | - Kotaro Kuwaki
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.,Inflammatory Bowel Disease Center, Kurume University School of Medicine, Kurume, Japan
| | - Ryosuke Yamauchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.,Inflammatory Bowel Disease Center, Kurume University School of Medicine, Kurume, Japan
| | - Tetsuhiro Yoshimura
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.,Inflammatory Bowel Disease Center, Kurume University School of Medicine, Kurume, Japan
| | - Toshihiro Araki
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.,Inflammatory Bowel Disease Center, Kurume University School of Medicine, Kurume, Japan
| | - Masaru Morita
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.,Inflammatory Bowel Disease Center, Kurume University School of Medicine, Kurume, Japan
| | - Kozo Tsuruta
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.,Inflammatory Bowel Disease Center, Kurume University School of Medicine, Kurume, Japan
| | - Sayo Yamasaki
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Kei Fukami
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Takuji Torimura
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
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12
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Hinson WD, Rogovskyy AS, Lawhon SD, Thieman Mankin KM. Influence of a cell salvage washing system and leukocyte reduction filtration on bacterial contamination of canine whole blood ex vivo. Vet Surg 2020; 49:989-996. [PMID: 32166777 DOI: 10.1111/vsu.13410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 12/12/2019] [Accepted: 02/24/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To determine the ability of cell salvage washing and leukoreduction filtration to remove bacterial contamination from canine whole blood. STUDY DESIGN Ex vivo nested cohort study. SAMPLE POPULATION Commercially purchased fresh canine whole blood (n = 33 units). METHODS Commercially obtained canine whole blood was inoculated with known concentrations of one of three species of bacteria, Escherichia coli (ATCC 25922), Staphylococcus pseudintermedius (quality control strain; Texas A&M University), or Pseudomonas aeruginosa (ATCC 27853). Negative controls were inoculated with sterile saline. The inoculated blood was processed through a cell salvage system and filtered through a series of two leukocyte reduction filters. Samples were aseptically collected at five points during processing (inoculum, prewash, postwash, post-first filtration, and post-second filtration) for bacterial enumeration. RESULTS Bacterial concentrations were reduced by 85.2%, 91.5%, and 93.9% for E coli, S pseudintermedius, and P aeruginosa, respectively, after washing (P < .0001), and bacterial concentrations were reduced by 99.9%, 100%, and 100%, respectively, after the first filtration (P < .0001). After the second filtration, none of the three species of bacteria could be isolated (100% reduction). No bacterial growth was obtained from negative controls throughout the study. The type of bacteria (P = .29) did not allow prediction of bacterial reduction. CONCLUSION Cell salvage washing combined with leukoreduction filtration eliminated bacterial contamination of whole dog blood (P < .0001). CLINICAL SIGNIFICANCE Cell salvage washing and leukoreduction filtration could be applied to intraoperative autotransfusion in clinical animals, especially those treated for trauma or hemorrhage with concurrent bacterial contamination.
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Affiliation(s)
- Whitney D Hinson
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M College of Veterinary Medicine, College Station, Texas
| | - Artem S Rogovskyy
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M College of Veterinary Medicine, College Station, Texas
| | - Sara D Lawhon
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M College of Veterinary Medicine, College Station, Texas
| | - Kelley M Thieman Mankin
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M College of Veterinary Medicine, College Station, Texas
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Myrga JM, Ayyash OM, Bandari J, Fam MM, Macleod LC, Jacobs BL, Davies BJ. The Safety and Short-term Outcomes of Leukocyte Depleted Autologous Transfusions During Radical Cystectomy. Urology 2019; 135:106-110. [PMID: 31626857 DOI: 10.1016/j.urology.2019.08.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 08/18/2019] [Accepted: 08/21/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To examine long- and short-term outcomes using cell salvage with a commercially available leukocyte depletion filter following radical cystectomy in an oncologic population. MATERIALS AND METHODS One hundred and fifty-seven patients, 87 of whom received a cell salvage transfusion, were retrospectively identified from chart review. Ninety-day outcomes as well as long-term mortality and cancer recurrence data were collected. Chi-square, Student's t, or Mann-Whitney U tests were used as appropriate. Multivariable regressions of survival were performed with a Cox proportional-hazards model. RESULTS Those who received a cell salvage transfusion did not show any differences in rate of cancer recurrence (23%) vs those who did not receive a cell salvage transfusion (24%; P = .85). There were also no differences noted in mortality rates between the 2 populations (12% vs 17%; P = .36). Furthermore, no differences were noted in postoperative complication rates, length of hospital stay, 90-day culture positive infections or readmissions (P >.05). CONCLUSION There are no significant differences in short-term or long-term patient outcomes between those who did and did not receive an intraoperative cell salvage transfusion. Cell salvage transfusions with a leukocyte depletion filter are safe and effective methods to reduce the need for allogeneic blood transfusions while controlling for the theoretical risk of metastatic spread.
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Affiliation(s)
- John M Myrga
- University of Pittsburgh School of Medicine, Pittsburgh, PA; University of Pittsburgh School of Medicine, Department of Urology, Pittsburgh, PA.
| | - Omar M Ayyash
- University of Pittsburgh School of Medicine, Department of Urology, Pittsburgh, PA
| | - Jathin Bandari
- University of Pittsburgh School of Medicine, Department of Urology, Pittsburgh, PA
| | - Mina M Fam
- Jersey Shore University Medical Center, Monmouth, NJ
| | | | - Bruce L Jacobs
- University of Pittsburgh School of Medicine, Department of Urology, Pittsburgh, PA
| | - Benjamin J Davies
- University of Pittsburgh School of Medicine, Department of Urology, Pittsburgh, PA
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14
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Yost G, Murray O, Kutz-McClain P, Koch A, Delaney ML, DuBois AM, Onderdonk AB, Geller S, Dobiesz V. Interval analysis of blood filtration efficacy in novel device for autotransfusion in postpartum hemorrhage. J Med Eng Technol 2019; 43:248-254. [PMID: 31478761 DOI: 10.1080/03091902.2019.1653392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Postpartum haemorrhage (PPH), the leading cause of maternal mortality, is particularly problematic in low resource settings where access to safe blood supplies and definitive medical treatment is limited. We describe the continued development of an autotransfusion device designed to treat PPH by collection, filtration and infusion of maternal blood. Previous study has demonstrated that the device effectively moves blood through a filtration apparatus and removes up to 97% of aerobic bacteria but had poor anaerobic bacteria reduction. In this study, we investigate the filtration efficacy of the device using configurations comprised of three different leukocyte depletion filter designs: the Pall Leukoguard RS leukocyte reduction filter (PLRF), the Haemonetics BPF4™ (BPF4) leukocyte reduction filter, and the Haemonetics SCRC Leukotrap® (SCRC) filter. All configurations performed well with reductions ranging from 49 to 98%. Configurations containing 2 Haemonetics SCRC Leukotrap®filters (configuration 5 and 6) consistently reduced anaerobic bacteria by at least 73%. These results indicate that utilising a combination of SCRC and PLRF filters confers a high level of microbial filtration with improved removal of anaerobic organisms.
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Affiliation(s)
- Gardner Yost
- College of Medicine, University of Illinois at Chicago , Chicago , IL , USA
| | - Olivia Murray
- College of Medicine, University of Illinois at Chicago , Chicago , IL , USA
| | - Pam Kutz-McClain
- College of Medicine, University of Illinois at Chicago , Chicago , IL , USA
| | - Abby Koch
- Center for Research on Women and Gender, University of Illinois at Chicago , Chicago , IL , USA
| | - Mary L Delaney
- Department of Pathology, Brigham and Women's Hospital , Boston , MA , USA
| | - Andrea M DuBois
- Department of Pathology, Brigham and Women's Hospital , Boston , MA , USA
| | - Andrew B Onderdonk
- Department of Pathology, Brigham and Women's Hospital , Boston , MA , USA
| | - Stacie Geller
- Center for Research on Women and Gender, University of Illinois at Chicago , Chicago , IL , USA
| | - Valerie Dobiesz
- Department of Emergency Medicine, Brigham and Women's Hospital , Boston , MA , USA
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15
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Siddon AJ, Tormey CA, Snyder EL. Platelet Transfusion Medicine. Platelets 2019. [DOI: 10.1016/b978-0-12-813456-6.00064-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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16
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Loi MM, Kelher M, Dzieciatkowska M, Hansen KC, Banerjee A, West FB, Stanley C, Briel M, Silliman CC. A comparison of different methods of red blood cell leukoreduction and additive solutions on the accumulation of neutrophil-priming activity during storage. Transfusion 2018; 58:2003-2012. [PMID: 30171813 DOI: 10.1111/trf.14788] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 02/21/2018] [Accepted: 03/15/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Three methods of leukoreduction (LR) are used worldwide: filtration, buffy coat removal (BCR), and a combination of the previous two methods. Additionally, there are a number of additive solutions (ASs) used to preserve red blood cell (RBC) function throughout storage. During RBC storage, proinflammatory activity accumulates; thus, we hypothesize that both the method of LR and the AS affect the accumulation of proinflammatory activity. STUDY DESIGN AND METHODS Ten units of whole blood were drawn from healthy donors, the RBC units were isolated, divided in half by weight, and leukoreduced by: 1) BCR, 2) filtration, or 3) BCR and filtration (combination-LR); stored in bags containing AS-3 per AABB criteria; and sampled weekly. The supernatants were isolated and frozen (-80°C). RBC units drawn from healthy donors into AS-1-, AS-3-, or AS-5-containing bags were also stored and sampled weekly, and the supernatants were isolated and frozen. The supernatants were assayed for neutrophil (PMN)-priming activity and underwent proteomic analyses. RESULTS Filtration and combination LR decreased priming activity accumulation versus buffy coat LR, although the accumulation of priming activity was not different during storage. Combination LR increased hemolysis versus filtration via proteomic analysis. Priming activity from AS-3 units was significant later in storage versus AS-1- or AS-5-stored units. CONCLUSIONS Although both filtration and combination LR decrease the accumulation of proinflammatory activity versus buffy coat LR, combination LR is not more advantageous over filtration, has increased costs, and may cause increased hemolysis. In addition, AS-3 decreases the early accumulation of PMN-priming activity during storage versus AS-1 or AS-5.
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Affiliation(s)
- Michele M Loi
- Department of Research Laboratory, University of Colorado Denver, Aurora, Colorado.,Department of Pediatrics, University of Colorado Denver, Aurora, Colorado
| | - Marguerite Kelher
- Department of Research Laboratory, University of Colorado Denver, Aurora, Colorado.,Department of Surgery, University of Colorado Denver, Aurora, Colorado
| | - Monika Dzieciatkowska
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver, Aurora, Colorado
| | - Kirk C Hansen
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver, Aurora, Colorado
| | - Anirban Banerjee
- Department of Surgery, University of Colorado Denver, Aurora, Colorado
| | - F Bernadette West
- Connecticut, Mid-Atlantic, and Appalachian Regions, American Red Cross, Hartford, Connecticut
| | | | - Matthew Briel
- Manufacturing, Bonfils Blood Center, Denver, Colorado
| | - Christopher C Silliman
- Department of Research Laboratory, University of Colorado Denver, Aurora, Colorado.,Department of Pediatrics, University of Colorado Denver, Aurora, Colorado.,Department of Surgery, University of Colorado Denver, Aurora, Colorado
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17
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Rygård SL, Jonsson AB, Madsen MB, Perner A, Holst LB, Johansson PI, Wetterslev J. Effects of red blood cell storage time on transfused patients in the ICU-protocol for a systematic review. Acta Anaesthesiol Scand 2017; 61:1384-1397. [PMID: 28901549 DOI: 10.1111/aas.12991] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 08/18/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND Patients in the intensive care unit (ICU) are often anaemic due to blood loss, impaired red blood cell (RBC) production and increased RBC destruction. In some studies, more than half of the patients were treated with RBC transfusion. During storage, the RBC and the storage medium undergo changes, which lead to impaired transportation and delivery of oxygen and may also promote an inflammatory response. Divergent results on the clinical consequences of storage have been reported in both observational studies and randomised trials. Therefore, we aim to gather and review the present evidence to assess the effects of shorter vs. longer storage time of transfused RBCs for ICU patients. METHODS We will conduct a systematic review with meta-analyses and trial sequential analyses of randomised clinical trials, and also include results of severe adverse events from large observational studies. Participants will be adult patients admitted to an ICU and treated with shorter vs. longer stored RBC units. We will systematically search the Cochrane Library, MEDLINE, Embase, BIOSIS, CINAHL and Science Citation Index for relevant literature, and we will follow the recommendation by the Cochrane Collaboration and the Preferred Reporting Items for Systemtic Review and Meta-Analysis (PRISMA)-statement. We will assess the risk of bias and random errors, and we will use the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to evaluate the overall quality of evidence. CONCLUSION We need a high-quality systematic review to summarise the clinical consequences of RBC storage time among ICU patients.
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Affiliation(s)
- S. L. Rygård
- Department of Intensive Care, 4131; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - A. B. Jonsson
- Department of Intensive Care, 4131; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - M. B. Madsen
- Department of Intensive Care, 4131; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - A. Perner
- Department of Intensive Care, 4131; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
- Centre for Research in Intensive Care (CRIC); Copenhagen Denmark
| | - L. B. Holst
- Department of Intensive Care, 4131; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - P. I. Johansson
- Department of Transfusion Medicine; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - J. Wetterslev
- Centre for Research in Intensive Care (CRIC); Copenhagen Denmark
- Copenhagen Trial Unit; Centre for Clinical Intervention Research; Copenhagen University Hospital; Rigshospitalet Copenhagen Denmark
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18
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Pourbaghi R, Zarrebini M, Semnani D, Pourazar A, Akbari N, Shamsfar R. Evaluation of polyacrylonitrile electrospun nano-fibrous mats as leukocyte removal filter media. J Biomed Mater Res B Appl Biomater 2017; 106:1759-1769. [DOI: 10.1002/jbm.b.33980] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 07/12/2017] [Accepted: 08/16/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Raha Pourbaghi
- Department of Textile Engineering; Isfahan University of Technology; Isfahan Iran
| | - Mohammad Zarrebini
- Department of Textile Engineering; Isfahan University of Technology; Isfahan Iran
| | - Dariush Semnani
- Department of Textile Engineering; Isfahan University of Technology; Isfahan Iran
| | - Abbasali Pourazar
- Department of Immunology; School of Medicine, Isfahan University of Medical Sciences; Isfahan Iran
| | - Nahid Akbari
- Isfahan Blood Transfusion Organization; Isfahan Iran
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19
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Chen YW, Venault A, Jhong JF, Ho HT, Liu CC, Lee RH, Hsiue GH, Chang Y. Developing blood leukocytes depletion membranes from the design of bio-inert PEGylated hydrogel interfaces with surface charge control. J Memb Sci 2017. [DOI: 10.1016/j.memsci.2017.05.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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20
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Yost G, Collofello B, Goba G, Koch A, Harrington A, Esmailbeigi H, Robinson N, Kutz-McClain P, Geller S, Dobiesz V. A novel obstetric medical device designed for autotransfusion of blood in life threatening postpartum haemorrhage. J Med Eng Technol 2017; 41:515-521. [PMID: 28849957 DOI: 10.1080/03091902.2017.1364308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Postpartum haemorrhage (PPH) is an obstetric emergency caused by excessive blood loss after delivery, which is the leading cause of maternal mortality worldwide. PPH can lead to volume depletion, hypovolemic shock, anaemia and ultimately death. The prevalence of PPH is disproportionately higher in low resource settings where there is limited access to skilled medical care and safe blood supplies. Current management strategies target both prevention and treatment of PPH however no alternatives currently exist to address the lack of safe blood supplies which are considered essential in emergency obstetrical care. Autotransfusion is used to salvage blood loss in a variety of clinical settings but has never been used in the context of vaginal delivery. We describe the development and testing of a novel device for the collection, filtration and autotransfusion of blood lost due to PPH. The prototype device is inexpensive and easily operated so that it may be practically deployed in low resource settings. The device is comprised of a blood collection drape, a pump apparatus, three leukocyte reduction filters and a reservoir for filtered blood. Preliminary testing demonstrates efficacy of microbial load reduction of up to 97.3%. To reduce cost and improve safety, the device is modular in design such that the drape, tubing, filters and transfusion bag may be stored sterile, used once and discarded; while the pump apparatus may be used indefinitely without the need for sterilisation. Preliminary results indicate the device confers a low cost and potentially effective means of collecting, pumping, filtering and returning blood to a patient following PPH in settings that lack safe blood supplies. This device shows promise as a method of stabilising patients suffering of PPH in low resource settings until definitive treatment is rendered with the ultimate goal of reducing maternal mortality globally.
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Affiliation(s)
- Gardner Yost
- a College of Medicine , University of Illinois at Chicago , IL , USA
| | | | - Gelila Goba
- b Department of Obstetrics and Gynecology , University of Illinois , Chicago , IL , USA
| | - Abigail Koch
- c Center for Research on Women and Gender , University of Illinois , Chicago , IL , USA
| | - Amanda Harrington
- d Department of Pathology , Loyola University Medical Center , Maywood , IL , USA
| | - Hananeh Esmailbeigi
- e Department of Bioengineering , University of Illinois , Chicago , IL , USA
| | - Nuriya Robinson
- f Department of Obstetrics and Gynecology , Harbor-UCLA Medical Center , Torrance , CA , USA
| | | | - Stacie Geller
- b Department of Obstetrics and Gynecology , University of Illinois , Chicago , IL , USA.,c Center for Research on Women and Gender , University of Illinois , Chicago , IL , USA
| | - Valerie Dobiesz
- h Harvard Medical School , Brigham & Women's Hospital , Boston , MA , USA
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21
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Seo J, Seo JH. Fabrication of an Anti-Biofouling Plasma-Filtration Membrane by an Electrospinning Process Using Photo-Cross-linkable Zwitterionic Phospholipid Polymers. ACS APPLIED MATERIALS & INTERFACES 2017; 9:19591-19600. [PMID: 28535035 DOI: 10.1021/acsami.7b03308] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The goal of this study is to fabricate a stable plasma filtration membrane with antibiofouling properties via an electrospinning process. To this end, a random-type copolymer consisting of zwitterionic phosphorylcholine (PC) groups and ultraviolet (UV)-cross-linkable phenyl azide groups was synthesized. The zwitterionic PC group provides antibiofouling properties, and the phenyl azide group enables the stable maintenance of the fibrous nanostructure of hydrophilic zwitterion polymers in aqueous medium via a simple UV curing process. To demonstrate the antibiofouling nature of the PC group, a polymer without antibiofouling PC groups was also prepared for comparison. The successful synthesis of the random-type copolymers containing phenyl azide groups was proven by 1H nuclear magnetic resonance and Fourier transform infrared spectroscopy, and the fibrous structure of the prepared membranes was observed by field emission scanning electron microscopy. The antibiofouling properties were analyzed by fluorescein isothiocyanate-labeled bovine serum albumin adsorption and platelet adhesion tests. The experimental results show that membranes containing zwitterionic PC groups exhibited obvious decreases in platelet adhesion and protein adsorption. Platelet-rich plasma solution was filtered using the prepared membranes to test their filtration properties. The sequential filtration process removed 80% and almost 98% of the platelets. This finding confirmed that the membrane retained its blood-inert biomaterial surface in a complex medium that included blood plasma and platelets.
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Affiliation(s)
- Jiae Seo
- Department of Materials Science and Engineering, Korea University , 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Ji-Hun Seo
- Department of Materials Science and Engineering, Korea University , 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Korea
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22
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Muro SM, Lee JH, Stokes JV, Ross MK, Archer TM, Wills RW, Mackin AJ, Thomason JM. Effects of Leukoreduction and Storage on Erythrocyte Phosphatidylserine Expression and Eicosanoid Concentrations in Units of Canine Packed Red Blood Cells. J Vet Intern Med 2017; 31:410-418. [PMID: 28140476 PMCID: PMC5354049 DOI: 10.1111/jvim.14664] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 10/14/2016] [Accepted: 01/04/2017] [Indexed: 12/11/2022] Open
Abstract
Background Storage of canine packed red blood cells (pRBCs) can increase erythrocyte phosphatidylserine (PS) expression and eicosanoid concentrations. Hypothesis/Objectives To determine the effects of leukoreduction on erythrocyte PS expression and eicosanoid concentrations in stored units of canine pRBCs. Our hypothesis was that leukoreduction would decrease PS expression and eicosanoid concentrations. Animals Eight healthy dogs. Methods In a cross‐over study, units of whole blood were leukoreduced (LR) or non‐LR and stored (10 and 21 days) as pRBCs. Samples were collected at donation, and before and after a simulated transfusion. PS expression was measured by flow cytometry, and concentrations of arachidonic acid (AA), prostaglandin F2α (PGF2α), prostaglandin E2 (PGE2), prostaglandin D2 (PGD2), thromboxane B2 (TXB2), 6‐keto‐prostaglandin F1α (6‐keto‐PGF1α), and leukotriene B4 (LTB4) were quantified by liquid chromatography–mass spectrometry. Results There was no change in PS expression during leukoreduction, storage, and simulated transfusion for non‐LR and LR units. Immediately after leukoreduction, there was a significant increase in TXB2 and PGF2α concentrations, but during storage, these eicosanoids decreased to non‐LR concentrations. In both LR and non‐LR units, 6‐keto‐PGF1α concentrations increased during storage and simulated transfusion, but there was no difference between unit type. There was no difference in AA, LTB4, PGE2, and PGD2 concentrations between unit types. Conclusions and Clinical Importance Leukoreduction, storage, and simulated transfusion do not alter erythrocyte PS expression. Leukoreduction causes an immediate increase in concentrations of TXB2 and PGF2α, but concentrations decrease to non‐LR concentrations with storage. Leukoreduction does not decrease the accumulation of 6‐keto‐PGF1α during storage.
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Affiliation(s)
- S M Muro
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS
| | - J H Lee
- Department of Basic Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS
| | - J V Stokes
- Department of Basic Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS
| | - M K Ross
- Department of Basic Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS
| | - T M Archer
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS
| | - R W Wills
- Department of Pathobiology and Population Medicine (Wills), College of Veterinary Medicine, Mississippi State University, Mississippi State, MS
| | - A J Mackin
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS
| | - J M Thomason
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS
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23
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A high-throughput microfluidic approach for 1000-fold leukocyte reduction of platelet-rich plasma. Sci Rep 2016; 6:35943. [PMID: 27775049 PMCID: PMC5075940 DOI: 10.1038/srep35943] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 10/07/2016] [Indexed: 12/27/2022] Open
Abstract
Leukocyte reduction of donated blood products substantially reduces the risk of a number of transfusion-related complications. Current 'leukoreduction' filters operate by trapping leukocytes within specialized filtration material, while allowing desired blood components to pass through. However, the continuous release of inflammatory cytokines from the retained leukocytes, as well as the potential for platelet activation and clogging, are significant drawbacks of conventional 'dead end' filtration. To address these limitations, here we demonstrate our newly-developed 'controlled incremental filtration' (CIF) approach to perform high-throughput microfluidic removal of leukocytes from platelet-rich plasma (PRP) in a continuous flow regime. Leukocytes are separated from platelets within the PRP by progressively syphoning clarified PRP away from the concentrated leukocyte flowstream. Filtrate PRP collected from an optimally-designed CIF device typically showed a ~1000-fold (i.e. 99.9%) reduction in leukocyte concentration, while recovering >80% of the original platelets, at volumetric throughputs of ~1 mL/min. These results suggest that the CIF approach will enable users in many fields to now apply the advantages of microfluidic devices to particle separation, even for applications requiring macroscale flowrates.
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24
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Maglaras CH, Koenig A, Bedard DL, Brainard BM. Retrospective evaluation of the effect of red blood cell product age on occurrence of acute transfusion-related complications in dogs: 210 cases (2010-2012). J Vet Emerg Crit Care (San Antonio) 2016; 27:108-120. [PMID: 27669368 DOI: 10.1111/vec.12530] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 02/08/2015] [Accepted: 03/17/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To determine whether red blood cell (RBC) product age influences the occurrence of acute transfusion-related complications and mortality in dogs. The hypothesis was that acute transfusion-related complications and mortality would increase with age of product. DESIGN Retrospective study (2010-2012). SETTING University teaching hospital. ANIMALS Two hundred and ten clinical canine patients. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Medical records were reviewed for dogs receiving RBC-containing products. Patient signalment; reason for transfusion; product type, dose, age, and source; pretransfusion compatibility; rate, route, and method of administration; administration of multiple transfusions; underlying disease; occurrence of transfusion-related complications (eg, fever, hemolysis, gastrointestinal distress, cardiovascular, neurologic, and respiratory complications); various hematologic parameters; and survival were recorded. Data were analyzed for association between potential risk factors and occurrence of transfusion-related complications as well as between transfusion-related complications and survival. Of 333 transfusion events in 210 patients, 84 transfusion-related complications occurred. Fever was most common (41/333), followed by hemolysis (21/333). For every additional day of product age, the odds of hemolysis increased significantly (odds ratio, 1.11; 95% confidence interval, 1.06-1.16; P < 0.0001). Transfusion-related complications when considered as a whole were associated with higher dose of product, longer duration of administration per transfusion event, and immune-mediated disease, but not with source of product or general category of anemia. Administration rate was significantly slower in patients with febrile transfusion-related complications (P < 0.0001). Product age was not associated with increased mortality. CONCLUSIONS Age of stored RBC products is associated with increased risk of transfusion-related hemolysis, but not with fever. Prospective clinical studies evaluating the influence of storage duration on development of in vitro versus in vivo hemolysis are warranted.
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Affiliation(s)
- Christina H Maglaras
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602
| | - Amie Koenig
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602
| | - Deanna L Bedard
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602
| | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602
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25
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Begue S, Morel P, Djoudi R. [Innovative technology and blood safety]. Transfus Clin Biol 2016; 23:245-252. [PMID: 27616610 DOI: 10.1016/j.tracli.2016.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Accepted: 07/19/2016] [Indexed: 11/17/2022]
Abstract
If technological innovations are not enough alone to improve blood safety, their contributions for several decades in blood transfusion are major. The improvement of blood donation (new apheresis devices, RFID) or blood components (additive solutions, pathogen reduction technology, automated processing of platelets concentrates) or manufacturing process of these products (by automated processing of whole blood), all these steps where technological innovations were implemented, lead us to better traceability, more efficient processes, quality improvement of blood products and therefore increased blood safety for blood donors and patients. If we are on the threshold of a great change with the progress of pathogen reduction technology (for whole blood and red blood cells), we hope to see production of ex vivo red blood cells or platelets who are real and who open new conceptual paths on blood safety.
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Affiliation(s)
- S Begue
- Direction médicale, établissement français du sang, 20, avenue du Stade-de-France, 93218 La Plaine-Stade-de-France, France
| | - P Morel
- Établissement français du sang - Bourgogne-Franche Comté, 8, rue du Docteur-Jean-François-Xavier-Girod, 25000 Besançon, France
| | - R Djoudi
- Établissement français du sang - Île-de-France, 122/130, rue Marcel-Hartmann, LEAPARK bâtiment A, 94200 Ivry-sur-Seine, France.
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26
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Gehrie EA, Dunbar NM. Modifications to Blood Components: When to Use them and What is the Evidence? Hematol Oncol Clin North Am 2016; 30:653-63. [PMID: 27113002 DOI: 10.1016/j.hoc.2016.01.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Blood component modifications can be performed by the hospital blood bank for select clinical indications. In general, modification of blood components increases costs and may delay availability of the blood component because of the additional time required for some modification steps. However, the benefit of blood product modification may outweigh these concerns. Common modifications include leukoreduction, irradiation, volume reduction, splitting, and washing. Modification availability and selection practice may vary from hospital to hospital. In this article, available blood component modifications are described along with the benefits, drawbacks, and specific clinical indications supporting their use.
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Affiliation(s)
- Eric A Gehrie
- Department of Laboratory Medicine, Yale University School of Medicine, 20 York Street, Blood Bank PS329C, New Haven, CT 06510-3206, USA.
| | - Nancy M Dunbar
- Department of Pathology, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756-1000, USA; Department of Medicine, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756-1000, USA
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Corsi R, McMichael MA, Smith SA, O'Brien M, Herring J, Ngwenyama TR, Galligan A, Beloshapka AN, Deng P, Swanson KS. Cytokine concentration in stored canine erythrocyte concentrates. J Vet Emerg Crit Care (San Antonio) 2014; 24:259-63. [PMID: 24697952 DOI: 10.1111/vec.12160] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Accepted: 12/29/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the effect of leukoreduction (LR) as compared to standard nonleukoreduced (NLR) units on cytokine concentrations in canine erythrocyte concentrates during regular storage time. DESIGN Randomized, experimental study. SETTING University teaching hospital. ANIMALS Ten random-source research dogs. INTERVENTIONS One unit of whole blood was collected from each dog and randomized to standard processing (NLR, n = 5) or prestorage LR (n = 5). All units were stored at 4°C. Samples were aseptically collected from each unit weekly for 5 weeks. On day 35, 1 mL of blood was collected from each unit and submitted for aerobic culture. MEASUREMENT AND MAIN RESULTS An ELISA assay was used to analyze the concentrations of IL-1β, IL-8, TNF-α, and IL-10. There were no significant effects of either group or storage time for IL-1β, IL-10, or TNF-α. IL-8 concentration was significantly increased over the storage period in NLR units, and was significantly higher compared to LR units on days 28 and 35. Aerobic culture was negative on all units. CONCLUSIONS This study demonstrated a marked, storage time-dependent accumulation of IL-8 in canine erythrocyte concentrates. Prestorage LR attenuated the accumulation of IL-8. This chemokine may contribute to the proinflammatory effects of transfusion of stored erythrocyte concentrates.
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Affiliation(s)
- Raffaella Corsi
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Illinois at Urbana-Cham-paign, Urbana, IL, 61802
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Oldhafer KJ, Stavrou GA, Donati M, Kaudel P, Frühauf NR. Extracorporeal tumor cell filtration during extended liver surgery: first clinical use of leukocyte depletion filters--case series. World J Surg Oncol 2013; 11:159. [PMID: 23866965 PMCID: PMC3721985 DOI: 10.1186/1477-7819-11-159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 07/07/2013] [Indexed: 01/30/2023] Open
Abstract
Background During oncologic surgery, intraoperative manipulation of tumor tissue is almost unpreventable and causes a high risk of tumor cell dissemination into venous blood. A tumor cell-reducing effect of leukocyte adhesion filter systems has been shown under in vitro conditions. Methods In a first clinical attempt, leukocyte adhesion filters were integrated into veno-venous bypass systems in four patients undergoing extended liver surgery for secondary hepatic malignancies. Practicability, handling, and safety aspects as well as potency of cell removal and clinical side effects of the filter system were analyzed. Results All patients tolerated the application of the system without problems during operative and postoperative follow-up. Immunohistochemical staining of perioperative blood samples detected cytokeratin positive (CK+) cells in three cases during the hepatic mobilization. Conclusions Effectiveness of CK+ cell depletion and safety of the procedure was shown. The presented surgical technique represents a safe and innovative tool; however, clinical significance has to be examined in a larger patient cohort.
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Affiliation(s)
- Karl J Oldhafer
- Department of General and Abdominal Surgery, Asklepios Hospital Barmbek, Rübenkamp 220, 22293 Hamburg, Germany.
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Herring JM, Smith SA, McMichael MA, O'Brien M, Ngwenyama TR, Corsi R, Galligan A, Beloshapka AN, Deng P, Swanson KS. Microparticles in stored canine RBC concentrates. Vet Clin Pathol 2013; 42:163-9. [DOI: 10.1111/vcp.12034] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Jennifer M. Herring
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; University of Illinois; Urbana; IL; USA
| | - Stephanie A. Smith
- Department of Biochemistry; College of Medicine; University of Illinois; Urbana; IL; USA
| | - Maureen A. McMichael
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; University of Illinois; Urbana; IL; USA
| | - Mauria O'Brien
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; University of Illinois; Urbana; IL; USA
| | - Thandeka R. Ngwenyama
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; University of Illinois; Urbana; IL; USA
| | - Raffaella Corsi
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; University of Illinois; Urbana; IL; USA
| | - Alyssa Galligan
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; University of Illinois; Urbana; IL; USA
| | - Alison N. Beloshapka
- Department of Animal Sciences; College of Agricultural, Consumer & Environmental Sciences; University of Illinois; Urbana; IL; USA
| | - Ping Deng
- Department of Animal Sciences; College of Agricultural, Consumer & Environmental Sciences; University of Illinois; Urbana; IL; USA
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Nollet KE, Saito S, Ono T, Ngoma A, Ohto H. Microparticle formation in apheresis platelets is not affected by three leukoreduction filters. Transfusion 2013; 53:2293-8. [DOI: 10.1111/trf.12088] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 11/12/2012] [Accepted: 11/23/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Kenneth E. Nollet
- Department of Blood Transfusion and Transplantation Immunology; Fukushima Medical University; Fukushima; Japan
| | - Shunnichi Saito
- Department of Blood Transfusion and Transplantation Immunology; Fukushima Medical University; Fukushima; Japan
| | - Takako Ono
- Department of Blood Transfusion and Transplantation Immunology; Fukushima Medical University; Fukushima; Japan
| | - Alain Ngoma
- Department of Blood Transfusion and Transplantation Immunology; Fukushima Medical University; Fukushima; Japan
| | - Hitoshi Ohto
- Department of Blood Transfusion and Transplantation Immunology; Fukushima Medical University; Fukushima; Japan
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31
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Platelet Transfusion Medicine. Platelets 2013. [DOI: 10.1016/b978-0-12-387837-3.00062-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Should intraoperative cell-salvaged blood be used in patients with suspected or known malignancy? Can J Anaesth 2012; 59:1058-70. [PMID: 22996966 DOI: 10.1007/s12630-012-9781-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 08/23/2012] [Indexed: 01/15/2023] Open
Abstract
PURPOSE Intraoperative cell salvage (ICS) is used as an alternative to allogeneic blood transfusion in an attempt to avoid or minimize the risks associated with allogeneic blood. Intraoperative cell salvage is generally avoided in surgeries where malignancy is confirmed or suspected due to concern for potential metastasis or cancer recurrence. The application of post-processing methods for ICS is hypothesized to eliminate this potential risk. The purpose of this narrative review is to examine the in vitro experimental evidence as it pertains to the removal of tumour cells from ICS blood and to review the clinical studies where ICS blood has been used in patients with malignancy. SOURCE A search of the English literature for relevant articles published from 1973 to 2012 was undertaken using MEDLINE and Cochrane databases. Bibliographies were cross-referenced to locate further studies. PRINCIPAL FINDINGS Leukoreduction filters are an effective method for removal of malignant cells from ICS blood. Small non-randomized clinical studies to date do not show evidence of an increased rate of metastasis or cancer recurrence. Although a theoretical risk of disease recurrence persists, the decision to use autologous ICS blood must be weighed against the known risks of allogeneic blood transfusion. CONCLUSION Transfusion of autologous blood harvested via ICS should be considered a viable option for reduction or avoidance of allogeneic product during many oncologic surgeries and may be a lifesaving option for those patients who refuse allogeneic blood products.
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Campbell JP, Mackenzie MJ, Yentis SM, Sooranna SR, Johnson MR. An evaluation of the ability of leucocyte depletion filters to remove components of amniotic fluid*. Anaesthesia 2012; 67:1152-7. [DOI: 10.1111/j.1365-2044.2012.07247.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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34
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Gérard E, Bessy E, Hénard G, Verpoort T, Marchand-Brynaert J. Surface modification of polypropylene nonwovens with LDV peptidomimetics and their application in the leukodepletion of blood products. J Biomed Mater Res B Appl Biomater 2012; 100:1513-23. [DOI: 10.1002/jbm.b.32720] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 02/09/2012] [Accepted: 03/15/2012] [Indexed: 01/20/2023]
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PEACOCK LINZI, CLARK VICKI, CATLING SUE. Recent developments in the obstetric use of cell salvage. ACTA ACUST UNITED AC 2012. [DOI: 10.1111/j.1778-428x.2012.01160.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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36
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Autologous blood in obstetrics: where are we going now? BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2011; 10:125-47. [PMID: 22044959 DOI: 10.2450/2011.0010-11] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 01/29/2011] [Accepted: 06/06/2011] [Indexed: 11/21/2022]
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37
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Gérard E, Bessy E, Hénard G, Ducoroy L, Verpoort T, Marchand-Brynaert J. Surface modification of poly(butylene terephthalate) nonwoven by photochemistry and biofunctionalization with peptides for blood filtration. ACTA ACUST UNITED AC 2011. [DOI: 10.1002/pola.24975] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Okuzaki D, Kimura S, Yabuta N, Ohmine T, Nojima H. LeukoCatch, a quick and efficient tool for the preparation of leukocyte extracts from blood. BMC Clin Pathol 2011; 11:9. [PMID: 21849019 PMCID: PMC3170244 DOI: 10.1186/1472-6890-11-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Accepted: 08/17/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Whole-protein extracts from peripheral blood leukocytes are ideal for basic and clinical research. However, lack of a simple preparation technique has limited the use of such extracts. The aim of this study is to develop a simple and easy system that can selectively obtain leukocyte extracts without hemoglobin. METHODS A filter that captures the leukocytes but not RBCs was set at the bottom of a 10-mL medical syringe by sandwiching it between plastic stoppers. The capturing efficiency of leukocytes with this tool, called LeukoCatch, was examined using human macrophage cells (MONO-MAC-6). The abilities of LeukoCatch system to capture the leukocyte proteins and to remove the hemoglobin from RBCs were tested by western blot analysis using human blood samples. RESULTS This study presents the development of LeukoCatch, a novel tool that allows the preparation of leukocyte extracts from blood samples within 3 min without centrifugation. Tissue-cultured human macrophage cells were tested to determine the optimal filter numbers and pass-through frequencies of LeukoCatch, which was then applied to 2-mL blood samples. Samples were passed 2~5 times through a LeukoCatch equipped with 5 filters, washed twice with phosphate-buffered saline for red cell removal, and leukocyte proteins were extracted with 0.5 mL of elution buffer. Western blot analysis of the purified extract indicated that more than 90% of hemoglobin was removed by the LeukoCatch and that the protein recovery rate of leukocytes was at least 4 times better than that of the conventional centrifugation method. CONCLUSION We conclude that LeukoCatch is useful not only for diagnosis at the bedside but also for basic research using blood samples or tissue culture cells.
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Affiliation(s)
- Daisuke Okuzaki
- Department of Molecular Genetics, Research Institute for Microbial Diseases, Osaka University, 3-1 Yamadaoka, Suita, Osaka 565-0871, Japan.
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Sharma RR, Marwaha N. Leukoreduced blood components: Advantages and strategies for its implementation in developing countries. Asian J Transfus Sci 2011; 4:3-8. [PMID: 20376259 PMCID: PMC2847337 DOI: 10.4103/0973-6247.59384] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Removal of leucocytes from various blood products has been shown to minimize Febrile nonhemolytic transfusion reactions, HLA alloimmunization, platelet refractoriness in multitransfused patients and prevention of transmission of leukotropic viruses such as EBV and CMV. Rapidly growing size of hemato-oncological patients in our country requiring multiple transfusion of blood and components during the course of their management pose a great challenge to transfusion services to provide them red cell and platelet antigen matched products in alloimmunized subjects. Thus removal of leucocytes below a certain threshold, ≤ 5 × 106 in a blood component certainly helps in prevention of alloimmunization and associated risks in these patients. Currently the best Leucoreduction can be achieved with the help of 3rd and 4th generation leukofilters, both in laboratory and patient bed side, and state of the art apheresis devices. The present article briefly reviews the current literature for pros and cons of leucofilteration and its scope of implementation in the cost constrained settings.
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Affiliation(s)
- R R Sharma
- Department of Transfusion Medicine, PGIMER, Chandigarh, India
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41
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Abstract
Platelets are specialized blood cells that play central roles in physiologic and pathologic processes of hemostasis, wound healing, host defense, thrombosis, inflammation, and tumor metastasis. Activation of platelets is crucial for platelet function that includes a complex interplay of adhesion, signaling molecules, and release of bioactive factors. Transfusion of platelet concentrates is an important treatment component for thrombocytopenia and bleeding. Recent progress in high-throughput mRNA and protein profiling techniques has advanced the understanding of platelet biological functions toward identifying novel platelet-expressed and secreted proteins, analyzing functional changes between normal and pathologic states, and determining the effects of processing and storage on platelet concentrates for transfusion. It is important to understand the different standard methods of platelet preparation and how they differ from the perspective for use as research samples in clinical chemistry. Two simple methods are described here for the preparation of research-scale platelet samples from whole blood, and detailed notes are provided about the methods used for the preparation of platelet concentrates for transfusion.
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42
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Peytour Y, Guitart A, Villacreces A, Chevaleyre J, Lacombe F, Ivanovic Z, Praloran V. Obtaining of CD34+ cells from healthy blood donors: development of a rapid and efficient procedure using leukoreduction filters. Transfusion 2010; 50:2152-7. [PMID: 20456706 DOI: 10.1111/j.1537-2995.2010.02683.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Human CD34+ cells are mandatory to study many aspects of human hematopoiesis. Their low frequency in blood or marrow and ethical reasons limit their obtainment in large quantities. Leukoreduction filters (LRFs) are discarded after preparation of red blood cells. The CD34+ cell concentration in healthy donor blood is low (1×10(3) -4×10(3) /mL), but their number trapped in one LRF after filtration of 400 to 450mL of blood is high (0.4×10(6) -1.6×10(6) ). STUDY DESIGN AND METHODS To develop a procedure allowing obtainment of purified CD34+ cells from LRFs with a good yield, white blood cell (WBC) recoveries after a 500-mL continuous or after sequential elution (50- or 20-mL fractions) were compared. Different WBC and mononuclear cell (MNC) centrifugation methods were tested to minimize their PLT contamination before the CD34+ cell immunomagnetic selection. Cell functionality was finally analyzed under various culture conditions. RESULTS The 20-mL back-flushing of LRFs allowed the most efficient WBC recovery. The next steps (110×g centrifugation, MNC separation on Ficoll, and washes) resulted in a cell suspension in which the lymphocyte recovery was approximately 76±10% and the PLT contamination below 1.6%. After immunomagnetic selection, 4×10(5) to 6×10(5) cells containing approximately 85% of functional CD34+ cells were obtained. CONCLUSION This procedure allows the easy, rapid (<5hr), and efficient preparation of large quantities of CD34+ cells having functional activities similar to those of CD34+ cells from other sources. Therefore, easily available and virally safe, LRFs represent an important and regular WBC source to work with human CD34+ cells, but also with other WBC types.
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Affiliation(s)
- Yann Peytour
- CNRS UMR 5164, University of Bordeaux 2, Etablissement Français du Sang Aquitaine-Limousin, Laboratoire d'Hématologie, CHU of Bordeaux, Bordeaux, France
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De Palma A, Roveri A, Zaccarin M, Benazzi L, Daminelli S, Pantano G, Buttarello M, Ursini F, Gion M, Mauri PL. Extraction methods of red blood cell membrane proteins for Multidimensional Protein Identification Technology (MudPIT) analysis. J Chromatogr A 2010; 1217:5328-36. [PMID: 20621298 DOI: 10.1016/j.chroma.2010.06.045] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2010] [Accepted: 06/16/2010] [Indexed: 10/19/2022]
Abstract
Since red blood cells (RBCs) lack nuclei and organelles, cell membrane is their main load-bearing component and, according to a dynamic interaction with the cytoskeleton compartment, plays a pivotal role in their functioning. Even if erythrocyte membranes are available in large quantities, the low abundance and the hydrophobic nature of cell membrane proteins complicate their purification and detection by conventional 2D gel-based proteomic approaches. So, in order to increase the efficiency of RBC membrane proteome identification, here we took advantage of a simple and reproducible membrane sub-fractionation method coupled to Multidimensional Protein Identification Technology (MudPIT). In addition, the adoption of a stringent RBC filtration strategy from the whole blood, permitted to remove exhaustively contaminants, such as platelets and white blood cells, and to identify a total of 275 proteins in the three RBC membrane fractions collected and analysed. Finally, by means of software for the elaboration of the great quantity of data obtained and programs for statistical analysis and protein classification, it was possible to determine the validity of the entire system workflow and to assign the proper sub-cellular localization and function for the greatest number of the identified proteins.
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Affiliation(s)
- Antonella De Palma
- Proteomics and Metabolomics Unit, Institute for Biomedical Technologies-CNR, Via Fratelli Cervi 93, I-20090 Segrate, Milan, Italy
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Yamasaki H, Mitsuyama K, Masuda J, Tomiyasu N, Takedatsu H, Akashi H, Matsumoto S, Takedatsu H, Kuwaki K, Tsuruta O, Sata M. Mechanisms underlying the effects of leukocyte apheresis with a fiber filter in a rat model of dextran sulfate sodium-induced colitis. Dig Dis Sci 2010; 55:596-606. [PMID: 19259814 DOI: 10.1007/s10620-009-0768-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2008] [Accepted: 02/11/2009] [Indexed: 12/11/2022]
Abstract
While several clinical trials have suggested that leukocytapheresis (LCAP) by filtration can benefit patients with active ulcerative colitis, the mechanisms underlying these benefits are largely unknown. The aim of this study was to address the mechanisms that may underlie the therapeutic effects of LCAP using a dextran sulfate sodium-induced colitis model in rats. Treatment with the active column, but not the sham column, improved disease severity by down-regulating pro-inflammatory events, including the cell-proliferative responses and inflammatory cytokine and reactive oxygen production, as well as by up-regulating protective events, including hepatocyte growth factor production, bone marrow-derived endothelial progenitor cell induction, and colonic blood flow levels, which were mediated predominantly by calcitonin gene-related peptide. The improvement was also associated with the increase of Ki-67 labeling in the colonic epithelium. In conclusion, the LCAP procedure was used in a dextran sulfate sodium-induced colitis model in rats under extracorporeal circulation conditions. This approach down-regulated pro-inflammatory events and up-regulated protective events in association with disease improvement. These data suggest that LCAP is feasible in animals and should shed light on the mechanisms of LCAP in clinical settings.
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Affiliation(s)
- Hiroshi Yamasaki
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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Mitsuyama K, Sata M. Therapeutic leukocytapheresis in inflammatory bowel disease: clinical efficacy and mechanisms of action. Cytotherapy 2009; 11:229-37. [PMID: 19241197 DOI: 10.1080/14653240902725566] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Intense infiltration of the intestinal mucosa by activated leukocytes is a hallmark of inflammatory bowel disease (IBD). Therefore, removal of circulating leukocytes may be an attractive approach for treating IBD. Leukocytapheresis with Cellsorba, a column of polyethylenephtarate fibers that captures monocytes, granulocytes and lymphocytes, has been used to treat IBD, particularly ulcerative colitis, in Japan and Europe. This article reviews the clinical efficacy and safety data and the mechanisms of action of leukocytapheresis in IBD. Although the majority of clinical studies enrolled only small numbers of patients and had open-labeled designs, leukocytapheresis showed clinical efficacy with an excellent safety profile. Leukocytapheresis depletes granulocytes, monocytes, lymphocytes and platelets, alters cell population profiles, modulates cytokine production, and induces bone marrow-derived cells. In conclusion, leukocytapheresis exerts anti-inflammatory and tissue-repairing effects on the intestinal mucosa in IBD. Further studies are needed to explain the exact mechanism of action and to determine the true efficacy of this approach.
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Affiliation(s)
- Keiichi Mitsuyama
- Department of Medicine, Kurume University School of Medicine, Japan.
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46
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Ma SK, Wong KF, Siu L. Hemoglobinemia and hemoglobinuria complicating concomitant use of a white cell filter and a pressure infusion device. Transfusion 2009. [DOI: 10.1111/j.1537-2995.1995.tb03389.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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47
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Greening DW, Glenister KM, Sparrow RL, Simpson RJ. Enrichment of human platelet membranes for proteomic analysis. Methods Mol Biol 2009; 528:245-258. [PMID: 19153697 DOI: 10.1007/978-1-60327-310-7_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Platelets (thrombocytes) are the smallest human blood cells and are pivotal in processes of hemostasis and thrombosis. Central to their function, the activation of platelets includes a complex interplay of adhesion and signalling molecules mediated via the plasma and inner membrane. Because platelets are enucleated, the analysis of the proteome is the best way to approach their biology. Here, we employ mass spectrometry (MS)-based proteomics to characterise membrane proteins derived from non-stimulated human platelets. This protocol details the extraction and purification of platelet membrane proteins from whole blood using SDS-PAGE in conjunction with LC-MS/MS. This method allowed the identification, and characterization of 207 platelet membrane proteins (PMP) from approximately 9.95 x 10(9) platelets (16).
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Napier, Chapman, Forman, Kelsey, Knowles, Murphy, Williamson, Wood, Kinsey, Murphy, Pamphilon, Warwick. Guidelines on the clinical use of leucocyte‐depleted blood components. Transfus Med 2008. [DOI: 10.1046/j.1365-3148.1998.00129.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Napier
- British Committee for Standards in Haematology, Blood Transfusion Task Force
| | - Chapman
- British Committee for Standards in Haematology, Blood Transfusion Task Force
| | - Forman
- British Committee for Standards in Haematology, Blood Transfusion Task Force
| | - Kelsey
- British Committee for Standards in Haematology, Blood Transfusion Task Force
| | - Knowles
- British Committee for Standards in Haematology, Blood Transfusion Task Force
| | - Murphy
- British Committee for Standards in Haematology, Blood Transfusion Task Force
| | - Williamson
- British Committee for Standards in Haematology, Blood Transfusion Task Force
| | - Wood
- British Committee for Standards in Haematology, Blood Transfusion Task Force
| | - Kinsey
- British Committee for Standards in Haematology, Blood Transfusion Task Force
| | - Murphy
- British Committee for Standards in Haematology, Blood Transfusion Task Force
| | - Pamphilon
- British Committee for Standards in Haematology, Blood Transfusion Task Force
| | - Warwick
- British Committee for Standards in Haematology, Blood Transfusion Task Force
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Allam J, Cox M, Yentis SM. Cell salvage in obstetrics. Int J Obstet Anesth 2008; 17:37-45. [PMID: 18162201 DOI: 10.1016/j.ijoa.2007.08.001] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2007] [Revised: 04/01/2007] [Accepted: 08/01/2007] [Indexed: 11/26/2022]
Abstract
The safety of cell salvage in obstetrics has been questioned because of the presumed risk of precipitating amniotic fluid embolism and, to a lesser extent, maternal alloimmunisation. For these reasons, experience in this field is limited and has lagged far behind that in other surgical specialties. There has, however, been renewed interest in its use over recent years, mainly as a result of problems associated with allogeneic blood transfusion. Our aim was to review the medical literature to ascertain the principles of cell salvage, the ability of the process to remove contaminants, and its safety profile in the obstetric setting. The search engines PubMed and Google Scholar were used and relevant articles and websites hand searched for further references. Existing cell salvage systems differ in their ability to clear contaminants and all require the addition of a leucocyte depletion filter. Although large prospective trials of cell salvage with autotransfusion in obstetrics are lacking, to date, no single serious complication leading to poor maternal outcome has been directly attributed to its use. Cell salvage in obstetrics has been endorsed by several bodies based on current evidence. Current evidence supports the use of cell salvage in obstetrics, which is likely to become increasingly commonplace, but more data are required concerning its clinical use.
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Affiliation(s)
- J Allam
- Magill Department of Anaesthesia, Intensive Care and Pain Management, Chelsea and Westminster Hospital, London, UK.
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50
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Greening DW, Glenister KM, Kapp EA, Moritz RL, Sparrow RL, Lynch GW, Simpson RJ. Comparison of human platelet membrane-cytoskeletal proteins with the plasma proteome: Towards understanding the platelet-plasma nexus. Proteomics Clin Appl 2008; 2:63-77. [DOI: 10.1002/prca.200780067] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2007] [Indexed: 11/06/2022]
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