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Miglio A, Rocconi F, Cremoni V, D'Alessandro A, Reisz JA, Maslanka M, Lacroix IS, Di Francesco D, Antognoni MT, Di Tommaso M. Effect of leukoreduction on the omics phenotypes of canine packed red blood cells during refrigerated storage. J Vet Intern Med 2024; 38:1498-1511. [PMID: 38553798 PMCID: PMC11099828 DOI: 10.1111/jvim.17031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 02/16/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Red blood cell (RBC) storage promotes biochemical and morphological alterations, collectively referred to as storage lesions (SLs). Studies in humans have identified leukoreduction (LR) as a critical processing step that mitigates SLs. To date no study has evaluated the impact of LR on metabolic SLs in canine blood units using omics technologies. OBJECTIVE Compare the lipid and metabolic profiles of canine packed RBC (pRBC) units as a function of LR in fresh and stored refrigerated (up to 42 days) units. ANIMALS Packed RBC units were obtained from 8 donor dogs enrolled at 2 different Italian veterinary blood banks. STUDY DESIGN AND METHODS Observational study. A volume of 450 mL of whole blood was collected using Citrate-Phosphate-Dextrose-Saline-Adenine-Glucose-Mannitol (CPD-SAGM) transfusion bags with a LR filter to produce 2 pRBC units for each donor, without (nLR-pRBC) and with (LR-pRBC) LR. Units were stored in the blood bank at 4 ± 2°C. Sterile weekly samples were obtained from each unit for omics analyses. RESULTS A significant effect of LR on fresh and stored RBC metabolic phenotypes was observed. The nLR-pRBC were characterized by higher concentrations of free short and medium-chain fatty acids, carboxylic acids (pyruvate, lactate), and amino acids (arginine, cystine). The LR-pRBC had higher concentrations of glycolytic metabolites, high energy phosphate compounds (adenosine triphosphate [ATP]), and antioxidant metabolites (pentose phosphate, total glutathione). CONCLUSION AND CLINICAL IMPORTANCE Leukoreduction decreases the metabolic SLs of canine pRBC by preserving energy metabolism and preventing oxidative lesions.
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Affiliation(s)
- Arianna Miglio
- Department of Veterinary MedicineUniversity of Perugia, Via San Costanzo 4Perugia 06126Italy
| | - Francesca Rocconi
- Department of Veterinary MedicineVeterinary University Hospital, University of Teramo, Località Piano D'AccioTeramo 64100Italy
| | - Valentina Cremoni
- Department of Veterinary MedicineUniversity of Perugia, Via San Costanzo 4Perugia 06126Italy
| | - Angelo D'Alessandro
- Department of Biochemistry and Molecular GeneticsUniversity of Colorado Denver – Anschutz Medical CampusAuroraColoradoUSA
| | - Julie A. Reisz
- Department of Biochemistry and Molecular GeneticsUniversity of Colorado Denver – Anschutz Medical CampusAuroraColoradoUSA
| | - Mark Maslanka
- Department of Biochemistry and Molecular GeneticsUniversity of Colorado Denver – Anschutz Medical CampusAuroraColoradoUSA
| | - Ian S. Lacroix
- Department of Biochemistry and Molecular GeneticsUniversity of Colorado Denver – Anschutz Medical CampusAuroraColoradoUSA
| | - Daniela Di Francesco
- Department of Veterinary MedicineUniversity of Perugia, Via San Costanzo 4Perugia 06126Italy
| | - Maria T. Antognoni
- Department of Veterinary MedicineUniversity of Perugia, Via San Costanzo 4Perugia 06126Italy
| | - Morena Di Tommaso
- Department of Veterinary MedicineVeterinary University Hospital, University of Teramo, Località Piano D'AccioTeramo 64100Italy
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Davidow EB, Montgomery H, Mensing M. The influence of leukoreduction on the acute transfusion-related complication rate in 455 dogs receiving 730 packed RBCs: 2014-2017. J Vet Emerg Crit Care (San Antonio) 2022; 32:479-490. [PMID: 35043550 DOI: 10.1111/vec.13175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/22/2020] [Accepted: 07/25/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the influence of prestorage leukoreduction of packed RBCs (pRBCs) on acute transfusion-related complication rate in dogs. SETTING Two private referral hospitals. DESIGN Retrospective case study. ANIMALS Four hundred and fifty-five dogs receiving nonleukoreduced (nLR) or leukoreduced (LR) pRBC between January 1, 2014 and July 31, 2017. MEASUREMENTS AND MAIN RESULTS Transfusions were retrospectively reviewed to record data about the patient, donor, unit, transfusion event, acute complications, hospital discharge, and cause of death. Of 730 transfusion events in 455 dogs, 288 used LR pRBC and 442 used nLR pRBC. There was a 18.9% (138/730) overall complication rate. Seven (0.96%) complications were life-threatening. The most common complications were pyrexia (5.6%), gastrointestinal signs (4.9%), and hemolysis with no other signs (4.1%). Pyrexia with no other clinical signs, consistent with a febrile nonhemolytic transfusion reaction (FNHTR), occurred in 3.2% of transfusion events. There was a significant (P = 0.03) decrease in the rate of FNHTR with LR pRBC (1%) versus nLR pRBC (4.5%). Use of LR pRBC did not decrease in-hospital mortality. The odds of any complication, hemolysis only, FNHTR, and more severe complications increased with pRBC age. Leukoreduction did not decrease the impact of pRBC age on these complications. Use of older pRBC did not increase the incidence of life-threatening complications or mortality. Dogs receiving pRBC for blood loss were more likely to have gastrointestinal and more severe complications than those dogs that had hemolysis. The effect of pRBC unit age on complications was not influenced by the underlying reason for transfusion. Dogs that received a previous transfusion were more likely to have respiratory complications. CONCLUSION In this study, the use of LR pRBC was associated with a decreased rate of FNHTR but no other complications. Unit age was associated with the incidence of hemolysis, FNHTR, and complication severity but not the rate of life-threatening complications or mortality.
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Affiliation(s)
| | - Heather Montgomery
- ACCES Blood Bank, BluePearl Veterinary Partners, Seattle, Washington, USA
| | - Michelle Mensing
- ACCES Blood Bank, BluePearl Veterinary Partners, Seattle, Washington, USA
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Coll AC, Ross MK, Williams ML, Wills RW, Mackin AJ, Thomason JM. Effect of washing units of canine red blood cells on storage lesions. J Vet Intern Med 2021; 36:66-77. [PMID: 34939231 PMCID: PMC8783348 DOI: 10.1111/jvim.16340] [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: 03/04/2021] [Revised: 12/02/2021] [Accepted: 12/08/2021] [Indexed: 11/30/2022] Open
Abstract
Background In humans, washing stored blood products before transfusion reduces storage lesions and incidence of transfusion reactions, but the effectiveness of washing canine blood is unknown. Objectives The objective was to determine if manually washing units of stored blood would reduce storage lesions without adversely affecting erythrocytes. We hypothesized that washing stored units would reduce concentrations of storage lesions and cause minimal erythrocyte damage. Animals Eight healthy research dogs. Methods Repeated measure cohort study. Units of whole blood were stored for 28 days and washed 3 times with 0.9% NaCl. Blood samples were collected before and after storage, after each wash, and after being held at a simulated transfusion temperature. Variables measured included CBC variables, blood gas analysis, erythrocyte morphology, mean corpuscular fragility (MCF), and eicosanoid concentrations. A Friedman's test was used to evaluate changes in variables (P < .05 was considered significant). Results After the first wash, compared to values after storage, there was a significant decrease in potassium (4.3 mmol/L [4.0‐4.7] to 1.2 mmol/L [1‐1.6]; P < .0001, median [range]), lactate (1.45 mmol/L [1.07‐1.79] to 0.69 mmol/L [0.39‐0.93]; P = .002), and partial pressure carbon dioxide (102 mm Hg [80.2‐119.2] to 33.7 mm Hg [24.5‐44.5]; P < .0001), and increase in MCV (69.3 fL [65.7‐72.3] to 74 fL [69.6‐79.5]; P = .0003), and MCF (0.444 fL [0.279‐0.527] to 0.491 fL [0.43‐0.616]; P = .0006). Conclusions and Clinical Importance A single wash of stored whole blood significantly reduces most extracellular storage lesions, and additional washing might cause hemolysis.
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Affiliation(s)
- Ashley C Coll
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Matthew K Ross
- Department of Comparative Biomedical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Matthew L Williams
- Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Robert W Wills
- Department of Comparative Biomedical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Andrew J Mackin
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - John M Thomason
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
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Frank MJ, Khattab MR, Wills RW, Archer TM, Mackin AJ, Suchodolski JS, Lidbury JA, Steiner JM, Sullivant AM, Thomason JM. Effects of leukoreduction on N-methylhistamine concentration in stored units of canine whole blood. Am J Vet Res 2021; 82:890-896. [PMID: 34669495 DOI: 10.2460/ajvr.82.11.890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the effects of leukoreduction on N-methylhistamine (NMH; a stable histamine metabolite) concentration in units of canine whole blood during storage and incubation at room temperature (approx 22 °C) to simulate temperature conditions during transfusion. ANIMALS 8 healthy adult Walker Hounds. PROCEDURES A standard unit of blood (450 mL) was obtained from each dog twice, with at least 28 days between donations. Blood units collected from 4 dogs during the first donation underwent leukoreduction, whereas the blood units collected from the other 4 dogs did not undergo leukoreduction, prior to storage at 4 °C. The alternate treatment was applied to blood units collected during the second donation. A sample from each unit was obtained for determination of plasma NMH concentration the day of donation (before and after leukoreduction when applicable) and before and after incubation at room temperature for 5 hours on days 14 and 28 of storage. RESULTS Units that underwent leukoreduction had substantially lower leukocyte and platelet counts than nonleukoreduced units. Plasma NMH concentration increased immediately after leukoreduction but did not change significantly during the subsequent 28 days of storage, nor did it differ between units that did and did not undergo leukoreduction. CONCLUSIONS AND CLINICAL RELEVANCE Leukoreduction and simulated transfusion temperature did not affect the histamine load in units of canine whole blood during the first 28 days of storage. Further research is necessary to determine whether histamine contributes to the development and severity of blood transfusion reactions in dogs.
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Affiliation(s)
- Mariah J Frank
- From the Atlantic Veterinary Internal Medicine and Oncology Hospital, Towson, MD 21286
| | - Mohammad R Khattab
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843
| | - Robert W Wills
- Departments of Comparative Biomedical Sciences and Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762
| | - Todd M Archer
- Departments of Comparative Biomedical Sciences and Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762
| | - Andrew J Mackin
- Departments of Comparative Biomedical Sciences and Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843
| | - Jonathan A Lidbury
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843
| | - Joerg M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843
| | - Alyssa M Sullivant
- Departments of Comparative Biomedical Sciences and Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762
| | - John M Thomason
- Departments of Comparative Biomedical Sciences and Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762
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Spada E, Perego R, Baggiani L, Proverbio D. Effect of Leukoreduction by Pre-Storage Filtration on Coagulation Activity of Canine Plasma Collected for Transfusion. Vet Sci 2021; 8:vetsci8080157. [PMID: 34437479 PMCID: PMC8402778 DOI: 10.3390/vetsci8080157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/29/2021] [Accepted: 08/03/2021] [Indexed: 12/16/2022] Open
Abstract
Leukoreduction of blood products is a technique used to prevent leukocyte-induced transfusion reactions and is extensively used in human, but rarely in veterinary patients. The concentration of some coagulation proteins can be affected by the processing steps used for the preparation of leuko-reduced plasma units. In this study, we assessed the effect of leukoreduction on coagulation activity of canine plasma collected for transfusion. Ten plasma units, five obtained from non-leuko-reduced (non-LR) whole blood (WB) units and five from leuko-reduced (LR) WB units were evaluated. Prothrombin time (PT), activated partial thromboplastin time (aPTT), coagulation factor activities of factors (F) V, VIII, X, XI, and von Willebrand (vWF), fibrinogen and D-dimers content were assessed at collection (baseline value, D0) and after 7 days of frozen storage at −18 °C (D7). Compared to non-LR plasma units, LR units showed a statistically significant prolonged aPTT and reduced FXI activity. Filtration had no significant effect on the other factors and parameters evaluated. Filtration-dependent changes appear to have no impact on the therapeutic quality of plasma obtained from leuko-reduced whole blood, other than for FXI activity. Further studies on a larger sample size comparing the same unit before and after leukoreduction are needed to confirm these findings.
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Abstract
Transfusion medicine can be a lifesaving intervention. Component therapy has expanded the availability and blood products available. Patient safety and minimizing risk is important and can be accomplished through proper donor screening, collection, storage, compatibility testing, administration, and monitoring. The pros and cons of available products must be considered and tailored to each individual patient. Recent discoveries include new antigens and blood types, microbial effects on blood type, and the association between blood type and disease prevalence.
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Affiliation(s)
- Kendon W Kuo
- Emergency and Critical Care, Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, 1220 Wire Road, Auburn, AL 36849-5540, USA
| | - Maureen McMichael
- Emergency and Critical Care, Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, 1220 Wire Road, Auburn, AL 36849-5540, USA.
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Bosch Lozano L, Blois SL, Wood RD, Abrams-Ogg ACG, Bersenas AM, Bateman SW, Richardson DM. A pilot study evaluating the effects of prestorage leukoreduction on markers of inflammation in critically ill dogs receiving a blood transfusion. J Vet Emerg Crit Care (San Antonio) 2019; 29:385-390. [PMID: 31218809 DOI: 10.1111/vec.12857] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 06/22/2017] [Accepted: 07/01/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To compare markers of inflammation after transfusion of leukoreduced (LR) packed RBCs (pRBCs) versus non-LR pRBCs in dogs with critical illness requiring blood transfusion, and to report survival to discharge and rates of transfusion reactions in these dogs. DESIGN Prospective randomized blinded clinical study June 2014-September 2015. SETTING University veterinary teaching hospital. ANIMALS Twenty-three client-owned critically ill dogs, consecutively enrolled. INTERVENTIONS Dogs requiring a single pRBC transfusion were randomized into the LR or non-LR pRBC group. Exclusion criteria included: requirement for multiple blood products, history of previous blood transfusion, and administration of anti-inflammatory or immunosuppressive medication prior to enrollment. MEASUREMENTS Blood samples were obtained immediately prior to transfusion, then 2 and 24 hours following transfusion. Parameters measured at each time point included: PCV, WBC count, segmented and band neutrophil counts, fibrinogen, and plasma lactate and C-reactive protein concentrations. Acute patient physiologic and laboratory evaluation fast score was calculated on admission. RESULTS Eleven dogs were included in the LR group and 12 in the non-LR group; scores of illness severity were not significantly different between groups. Total WBC count was significantly higher in the non-LR versus LR group 24 hours following pRBC transfusion, but this difference was not evident 2 hours following transfusion. No other inflammatory parameters at any time point were significantly different between LR versus non-LR pRBC transfused dogs. Survival rates to discharge for LR and non-LR groups were 8/11 and 9/12, respectively. Acute transfusion reactions were identified in 1/11 and 2/12 dogs in the LR and non-LR group, respectively. All transfused blood was stored ≤12 days. CONCLUSIONS Most markers of inflammation did not significantly increase following transfusion of LR versus non-LR pRBCs stored ≤12 days in ill dogs. Further prospective, randomized trials are needed in clinically ill dogs to determine the benefit of prestorage leukoreduction.
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Affiliation(s)
- Luis Bosch Lozano
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Ontario, Canada
| | - Shauna L Blois
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Ontario, Canada
| | - R Darren Wood
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Ontario, Canada
| | - Anthony C G Abrams-Ogg
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Ontario, Canada
| | - Alexa M Bersenas
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Ontario, Canada
| | - Shane W Bateman
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Ontario, Canada
| | - Danielle M Richardson
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Ontario, Canada
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