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Isiksacan Z, William N, Senturk R, Boudreau L, Wooning C, Castellanos E, Isiksacan S, Yarmush ML, Acker JP, Usta OB. Extended supercooled storage of red blood cells. Commun Biol 2024; 7:765. [PMID: 38914723 PMCID: PMC11196592 DOI: 10.1038/s42003-024-06463-4] [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: 11/01/2023] [Accepted: 06/16/2024] [Indexed: 06/26/2024] Open
Abstract
Red blood cell (RBC) transfusions facilitate many life-saving acute and chronic interventions. Transfusions are enabled through the gold-standard hypothermic storage of RBCs. Today, the demand for RBC units is unfulfilled, partially due to the limited storage time, 6 weeks, in hypothermic storage. This time limit stems from high metabolism-driven storage lesions at +1-6 °C. A recent and promising alternative to hypothermic storage is the supercooled storage of RBCs at subzero temperatures, pioneered by our group. Here, we report on long-term supercooled storage of human RBCs at physiological hematocrit levels for up to 23 weeks. Specifically, we assess hypothermic RBC additive solutions for their ability to sustain supercooled storage. We find that a commercially formulated next-generation solution (Erythro-Sol 5) enables the best storage performance and can form the basis for further improvements to supercooled storage. Our analyses indicate that oxidative stress is a prominent time- and temperature-dependent injury during supercooled storage. Thus, we report on improved supercooled storage of RBCs at -5 °C by supplementing Erythro-Sol 5 with the exogenous antioxidants, resveratrol, serotonin, melatonin, and Trolox. Overall, this study shows the long-term preservation potential of supercooled storage of RBCs and establishes a foundation for further improvement toward clinical translation.
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Affiliation(s)
- Ziya Isiksacan
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children's, Boston, MA, USA
| | - Nishaka William
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - Rahime Senturk
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children's, Boston, MA, USA
- Department of Chemical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Luke Boudreau
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children's, Boston, MA, USA
| | - Celine Wooning
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children's, Boston, MA, USA
- Department of Human Biology, Scripps College, Claremont, CA, USA
| | - Emily Castellanos
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children's, Boston, MA, USA
- Department of Psychology, Amherst College, Amherst, MA, USA
| | - Salih Isiksacan
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children's, Boston, MA, USA
- Department of Electrical-Electronics Engineering, Bilkent University, Ankara, Turkey
| | - Martin L Yarmush
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children's, Boston, MA, USA
- Department of Biomedical Engineering, Rutgers University, Piscataway, NJ, USA
| | - Jason P Acker
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada.
- Innovation and Portfolio Management, Canadian Blood Services, Edmonton, AB, Canada.
| | - O Berk Usta
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
- Shriners Children's, Boston, MA, USA.
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Kersten BJ, Numan L, van der Schoot MM, de Jong M, Ramjankhan F, Aarts E, Oerlemans MIFJ, van Laake LW, de Waal EEC. FLAVOUR Study: FLow profiles And postoperative VasOplegia after continUous-flow left ventriculaR assist device implantation. J Cardiovasc Transl Res 2024; 17:252-264. [PMID: 38300356 PMCID: PMC11052811 DOI: 10.1007/s12265-023-10476-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 12/12/2023] [Indexed: 02/02/2024]
Abstract
This study aims to associate the incidence of postoperative vasoplegia and short-term survival to the implantation of various left ventricular assist devices differing in hemocompatibility and flow profiles. The overall incidence of vasoplegia was 25.3% (73/289 patients) and 30.3% (37/122), 25.0% (18/72), and 18.9% (18/95) in the axial flow (AXF), centrifugal flow (CF), and centrifugal flow with artificial pulse (CFAP) group, respectively. Vasoplegia was associated with longer intensive care (ICU) and hospital length of stay (LOS) and mortality. ICU and in-hospital LOS and 1-year mortality were the lowest in the CFAP group. Post hoc analysis resulted in a p-value of 0.43 between AXF and CF; 0.35 between CF and CFAP; and 0.06 between AXF and CFAP. Although there is a trend in diminished incidence of vasoplegia, pooled logistic regression using flow profile and variables that remained after feature selection showed that flow profile was not an independent predictor for postoperative vasoplegia.
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Affiliation(s)
- Bas J Kersten
- Department of Anesthesiology, University Medical Center Utrecht, Post Office Box 85500, 3508, Utrecht, GA, Netherlands
| | - Lieke Numan
- Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Michel de Jong
- Heartbeat Perfusion, University Medical Center Utrecht, Utrecht, Netherlands
| | - Faiz Ramjankhan
- Department of Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Emmeke Aarts
- Department of Methodology and Statistics, Utrecht University, Utrecht, Netherlands
| | | | - Linda W van Laake
- Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Eric E C de Waal
- Department of Anesthesiology, University Medical Center Utrecht, Post Office Box 85500, 3508, Utrecht, GA, Netherlands.
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3
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Isiksacan Z, D’Alessandro A, Wolf SM, McKenna DH, Tessier SN, Kucukal E, Gokaltun AA, William N, Sandlin RD, Bischof J, Mohandas N, Busch MP, Elbuken C, Gurkan UA, Toner M, Acker JP, Yarmush ML, Usta OB. Assessment of stored red blood cells through lab-on-a-chip technologies for precision transfusion medicine. Proc Natl Acad Sci U S A 2023; 120:e2115616120. [PMID: 37494421 PMCID: PMC10410732 DOI: 10.1073/pnas.2115616120] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Abstract
Transfusion of red blood cells (RBCs) is one of the most valuable and widespread treatments in modern medicine. Lifesaving RBC transfusions are facilitated by the cold storage of RBC units in blood banks worldwide. Currently, RBC storage and subsequent transfusion practices are performed using simplistic workflows. More specifically, most blood banks follow the "first-in-first-out" principle to avoid wastage, whereas most healthcare providers prefer the "last-in-first-out" approach simply favoring chronologically younger RBCs. Neither approach addresses recent advances through -omics showing that stored RBC quality is highly variable depending on donor-, time-, and processing-specific factors. Thus, it is time to rethink our workflows in transfusion medicine taking advantage of novel technologies to perform RBC quality assessment. We imagine a future where lab-on-a-chip technologies utilize novel predictive markers of RBC quality identified by -omics and machine learning to usher in a new era of safer and precise transfusion medicine.
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Affiliation(s)
- Ziya Isiksacan
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA02114
- Shriners Children’s, Boston, MA02114
| | - Angelo D’Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver – Anschutz Medical Campus, Aurora, CO80045
| | - Susan M. Wolf
- Law School, Medical School, Consortium on Law and Values in Health, Environment & the Life Sciences, University of Minnesota, Minneapolis, MN55455
| | - David H. McKenna
- Division of Transfusion Medicine, Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN55455
| | - Shannon N. Tessier
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA02114
- Shriners Children’s, Boston, MA02114
| | | | - A. Aslihan Gokaltun
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA02114
- Shriners Children’s, Boston, MA02114
- Department of Chemical Engineering, Hacettepe University, Ankara06532, Turkey
| | - Nishaka William
- Laboratory Medicine and Pathology, University of Alberta, Edmonton, ABT6G 2R8, Canada
| | - Rebecca D. Sandlin
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA02114
| | - John Bischof
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, MN55455
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN55455
| | | | - Michael P. Busch
- Vitalant Research Institute, San Francisco, CA94105
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA94105
| | - Caglar Elbuken
- Institute of Materials Science and Nanotechnology, National Nanotechnology Research Center, Bilkent University, Ankara06800, Turkey
- Faculty of Biochemistry and Molecular Medicine, Faculty of Medicine, University of Oulu, 90014Oulu, Finland
- Valtion Teknillinen Tutkimuskeskus Technical Research Centre of Finland Ltd., 90570Oulu, Finland
| | - Umut A. Gurkan
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH44106
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH44106
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH44106
| | - Mehmet Toner
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA02114
- Shriners Children’s, Boston, MA02114
| | - Jason P. Acker
- Laboratory Medicine and Pathology, University of Alberta, Edmonton, ABT6G 2R8, Canada
- Innovation and Portfolio Management, Canadian Blood Services, Edmonton, ABT6G 2R8, Canada
| | - Martin L. Yarmush
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA02114
- Shriners Children’s, Boston, MA02114
- Department of Biomedical Engineering, Rutgers University, Piscataway, NJ08854
| | - O. Berk Usta
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA02114
- Shriners Children’s, Boston, MA02114
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Lai H, Wu G, Zhong Y, Chen G, Zhang W, Shi S, Xia Z. Red blood cell distribution width improves the prediction of 28-day mortality for patients with sepsis-induced acute kidney injury: A retrospective analysis from MIMIC-IV database using propensity score matching. JOURNAL OF INTENSIVE MEDICINE 2023; 3:275-282. [PMID: 37533812 PMCID: PMC10391576 DOI: 10.1016/j.jointm.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/02/2022] [Accepted: 02/07/2023] [Indexed: 08/04/2023]
Abstract
Background The predictive value of red blood cell distribution width (RDW) for mortality in patients with sepsis-induced acute kidney injury (SI-AKI) remains unclear. The present study aimed to investigate the potential association between RDW at admission and outcomes in patients with SI-AKI. Methods The Medical Information Mart for Intensive Care (MIMIC)-IV (version 2.0) database, released in June of 2022, provides medical data of SI-AKI patients to conduct our related research. Based on propensity score matching (PSM) method, the main risk factors associated with mortality in SI-AKI were evaluated using Cox proportional hazards regression analysis to construct a predictive nomogram. The concordance index (C-index) and decision curve analysis were used to validate the predictive ability and clinical utility of this model. Patients with SI-AKI were classified into the high- and low-RDW groups according to the best cut-off value obtained by calculating the maximum value of the Youden index. Results A total of 7574 patients with SI-AKI were identified according to the filter criteria. Compared with the low-RDW group, the high-RDW group had higher 28-day (9.49% vs. 31.40%, respectively, P <0.001) and 7-day (3.96% vs. 13.93%, respectively, P <0.001) mortality rates. Patients in the high-RDW group were more prone to AKI progression than those in the low-RDW group (20.80% vs. 13.60%, respectively, P <0.001). Based on matched patients, we developed a nomogram model that included age, white blood cells, RDW, combined hypertension and presence of a malignant tumor, treatment with vasopressor, dialysis, and invasive ventilation, sequential organ failure assessment, and AKI stages. The C-index for predicting the probability of 28-day survival was 0.799. Decision curve analysis revealed that the model with RDW offered greater net benefit than that without RDW. Conclusion The present findings demonstrated the importance of RDW, which improved the predictive ability of the nomogram model for the probability of survival in patients with SI-AKI.
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Affiliation(s)
- Honghao Lai
- Department of Burns, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong, China
- Department of Burns, Changhai Hospital, Naval Medical University, Shanghai 200433, China
- Research Institute, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong 510060, China
| | - Guosheng Wu
- Department of Burns, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Yu Zhong
- Department of Burns, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Guangping Chen
- Department of Burns, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong, China
| | - Wei Zhang
- Department of Burns, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Shengjun Shi
- Department of Burns, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong, China
| | - Zhaofan Xia
- Department of Burns, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong, China
- Department of Burns, Changhai Hospital, Naval Medical University, Shanghai 200433, China
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The impact of oxygen supply and erythrocytes during normothermic kidney perfusion. Sci Rep 2023; 13:2021. [PMID: 36737505 PMCID: PMC9898236 DOI: 10.1038/s41598-023-29031-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
The influence of erythrocytes and oxygen concentration on kidneys during long-term normothermic kidney perfusion is under debate. This study compares acellular and erythrocyte-based NMP with focus on oxygen delivery to the tissue as well as the effects of high oxygenation on tissue integrity. Pig kidneys were connected to NMP for six hours. The first group (n = 6; AC500) was perfused without addition of oxygen carriers, arterial perfusate pO2 was maintained at 500 mmHg. In the second group (n = 6; RBC500) washed erythrocytes were added to the perfusate at pO2 of 500 mmHg. Third group (n = 6; RBC200) was perfused with erythrocyte containing perfusate at more physiological pO2 of 200 mmHg. Addition of RBC did not relevantly increase oxygen consumption of the kidneys during perfusion. Likewise, there were no differences in kidney functional and injury parameters between AC500 and RBC500 group. Expression of erythropoietin as indicator of tissue hypoxia was comparable in all three groups. Cell free NMP at supraphysiological oxygen partial pressure seems to be a safe alternative to erythrocyte based perfusion without adverse effect on kidney integrity and provides a less cumbersome application of NMP in clinical practice.
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Amano M, Matsumoto M, Sano S, Oyama M, Nagumo H, Watanabe-Okochi N, Tsuno NH, Nakajima K, Muroi K. Characteristics of False-Positive Alarms in the BacT/Alert 3D System. Microbiol Spectr 2022; 10:e0005522. [PMID: 35467361 PMCID: PMC9241862 DOI: 10.1128/spectrum.00055-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/08/2022] [Indexed: 11/25/2022] Open
Abstract
The BacT/Alert system has been used for detecting the presence of bacteria in various clinical settings as well as in blood services, but it is associated with a relatively high incidence of false-positive results. We analyzed the results of our quality control sterility testing of blood products by BacT/Alert 3D to understand the mechanism of false-positive results. Anaerobic and aerobic bottles were inoculated with 10 mL of samples and cultured in BacT/Alert 3D for 10 days. Positive-reaction cases were classified as true positive if any bacterium was identified or false positive if the identification test had a negative result. The detection algorithm and the bottle graph pattern of the positive reaction cases were investigated. Among the 43,374 samples, 25 true positives (0.06%) and 29 false positives (0.07%) were observed. Although the detection algorithm of all true positives and 25 of 29 false positives was accelerating production of CO2, a steep rise in the bottle graph was observed only in the true positives, and it was not observed in either of the false positives. Four of 29 false positives were dependent on high baseline scatter reflections. Furthermore, evaluating the bottle graph pattern of Streptococcus pneumoniae, a bacterium known to autolyze, we confirmed that no viable bacterium was detected even if a steep rise was observed. In conclusion, the bottle graph pattern of positive reactions allows the differentiation between true positives and false positives. In case of a steep rise without bacterium detection, the bacterium might have autolyzed. Moreover, positive reactions with high baseline scatter reflections, despite immediate loading of bottles after sampling, are potentially false positive. IMPORTANCE In clinical settings, false-positive results are treated as positive until bacterial identification. It may result in the discarding of blood products in blood centers or affect clinical decisions in hospitals or testing facilities. Moreover, the management of these samples is usually time- and labor-consuming. The results of our study may help clinicians and laboratory staff in making a more precise evaluation of positive reactions in BacT/Alert.
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Affiliation(s)
- Misato Amano
- Kanto-Koshinetsu Block Blood Center, Japanese Red Cross Society, Tokyo, Japan
| | - Mami Matsumoto
- Central Blood Institute, Japanese Red Cross Society, Tokyo, Japan
| | - Shigeru Sano
- Kanto-Koshinetsu Block Blood Center, Japanese Red Cross Society, Tokyo, Japan
| | - Mayumi Oyama
- Kanto-Koshinetsu Block Blood Center, Japanese Red Cross Society, Tokyo, Japan
| | - Hideto Nagumo
- Central Blood Institute, Japanese Red Cross Society, Tokyo, Japan
| | | | - Nelson H. Tsuno
- Kanto-Koshinetsu Block Blood Center, Japanese Red Cross Society, Tokyo, Japan
| | - Kazunori Nakajima
- Kanto-Koshinetsu Block Blood Center, Japanese Red Cross Society, Tokyo, Japan
| | - Kazuo Muroi
- Kanto-Koshinetsu Block Blood Center, Japanese Red Cross Society, Tokyo, Japan
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Comparison of Two Alternative Procedures to Obtain Packed Red Blood Cells for β-Thalassemia Major Transfusion Therapy. Biomolecules 2021; 11:biom11111638. [PMID: 34827635 PMCID: PMC8615631 DOI: 10.3390/biom11111638] [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: 09/14/2021] [Revised: 10/29/2021] [Accepted: 11/02/2021] [Indexed: 11/16/2022] Open
Abstract
β-thalassemia major (βTM) patients require frequent blood transfusions, with consequences that span from allogenic reactions to iron overload. To minimize these effects, βTM patients periodically receive leucodepleted packed red blood cells (P-RBCs) stored for maximum 14 days. The aim of this study was to compare two alternative routine procedures to prepare the optimal P-RBCs product, in order to identify differences in their content that may somehow affect patients’ health and quality of life (QoL). In method 1, blood was leucodepleted and then separated to obtain P-RBCs, while in method 2 blood was separated and leucodepleted after removal of plasma and buffycoat. Forty blood donors were enrolled in two independent centers; couples of phenotypically matched whole blood units were pooled, divided in two identical bags and processed in parallel following the two methods. Biochemical properties, electrolytes and metabolic composition were tested after 2, 7 and 14 days of storage. Units prepared with both methods were confirmed to have all the requirements necessary for βTM transfusion therapy. Nevertheless, RBCs count and Hb content were found to be higher in method-1, while P-RBCs obtained with method 2 contained less K+, iron and storage lesions markers. Based on these results, both methods should be tested in a clinical perspective study to determine a possible reduction of transfusion-related complications, improving the QoL of βTM patients, which often need transfusions for the entire lifespan.
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Remakanth R, Abhishekh B. Is it an acute pain transfusion reaction? Asian J Transfus Sci 2021; 15:97-99. [PMID: 34349466 PMCID: PMC8294440 DOI: 10.4103/ajts.ajts_100_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 08/09/2020] [Accepted: 09/01/2020] [Indexed: 11/04/2022] Open
Abstract
A 40-year-old male patient presented to the emergency department with complaints of anasarca, mild dyspnea, orthopnea, vomiting, and decreased urine output. A provisional diagnosis of chronic kidney disease was made and planned for hemodialysis. In view of severe anemia, 1 packed red blood cell (PRBC) was requested and after pretransfusion testing one unit of buffy coat-poor, nonleucofiltered, coombs cross-match compatible, fresh (<7-days old) saline-adenine-glucose-mannitol PRBC unit was issued. After transfusion of around 20 ml of red cells patient developed sudden onset of excruciating pain in the lower back and hip joints, tachypnea, and breathlessness with oxygen saturation dropping to 82%. Vitals were normal and patient remained afebrile. After stopping transfusion, supplemental oxygen and opioid analgesic were given. Once the symptoms subsided, transfusion was completed. A complete work-up was done to rule out other adverse reactions. Thus, this patient experienced what is known as an acute pain transfusion reaction.
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Affiliation(s)
- Remi Remakanth
- Department of Transfusion Medicine, JIPMER, Puducherry, India
| | - B Abhishekh
- Department of Transfusion Medicine, JIPMER, Puducherry, India
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López-Canizales AM, Angulo-Molina A, Garibay-Escobar A, Silva-Campa E, Mendez-Rojas MA, Santacruz-Gómez K, Acosta-Elías M, Castañeda-Medina B, Soto-Puebla D, Álvarez-Bajo O, Burgara-Estrella A, Pedroza-Montero M. Nanoscale Changes on RBC Membrane Induced by Storage and Ionizing Radiation: A Mini-Review. Front Physiol 2021; 12:669455. [PMID: 34149450 PMCID: PMC8213202 DOI: 10.3389/fphys.2021.669455] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/10/2021] [Indexed: 11/25/2022] Open
Abstract
The storage lesions and the irradiation of blood cellular components for medical procedures in blood banks are events that may induce nanochanges in the membrane of red blood cells (RBCs). Alterations, such as the formation of pores and vesicles, reduce flexibility and compromise the overall erythrocyte integrity. This review discusses the alterations on erythrocytic lipid membrane bilayer through their characterization by confocal scanning microscopy, Raman, scanning electron microscopy, and atomic force microscopy techniques. The interrelated experimental results may address and shed light on the correlation of biomechanical and biochemical transformations induced in the membrane and cytoskeleton of stored and gamma-irradiated RBC. To highlight the main advantages of combining these experimental techniques simultaneously or sequentially, we discuss how those outcomes observed at micro- and nanoscale cell levels are useful as biomarkers of cell aging and storage damage.
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Affiliation(s)
| | - Aracely Angulo-Molina
- Departamento de Ciencias Químico-Biológicas, Universidad de Sonora, Hermosillo, Mexico
| | | | - Erika Silva-Campa
- Departamento de Investigación en Física, Universidad de Sonora, Hermosillo, Mexico
| | - Miguel A. Mendez-Rojas
- Departamento de Ciencias Químico-Biológicas, Universidad de las Américas, Puebla, Mexico
| | | | - Mónica Acosta-Elías
- Departamento de Investigación en Física, Universidad de Sonora, Hermosillo, Mexico
| | | | - Diego Soto-Puebla
- Departamento de Investigación en Física, Universidad de Sonora, Hermosillo, Mexico
| | - Osiris Álvarez-Bajo
- Departamento de Investigación en Física, Universidad de Sonora, Hermosillo, Mexico
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Mustafa I, Hadwan TAQ. Hemoglobin Oxidation in Stored Blood Accelerates Hemolysis and Oxidative Injury to Red Blood Cells. J Lab Physicians 2021; 12:244-249. [PMID: 33390673 PMCID: PMC7773440 DOI: 10.1055/s-0040-1721156] [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] [Indexed: 11/25/2022] Open
Abstract
Introduction
Maintaining blood supply is a challenge in blood banks. Red blood cells (RBCs) stored at 4°C experience issues of biochemical changes due to metabolism of cells, leading to changes collectively referred to as “storage lesions.” Oxidation of the red cell membrane, leading to lysis, contributes to these storage lesions.
Methods
Blood bags with CPD-SAGM stored at 4°C for 28 days were withdrawn aseptically on days 1, 14, and 28. Hematology analyzer was used to investigate RBC indices. Hemoglobin oxidation was studied through spectrophotometric scan of spectral change. RBC lysis was studied with the help of Drabkin's assay, and morphological changes were observed by light and scan electron microscopy.
Results
RBCs show progressive changes in morphology echinocytes and spherocytes on day 28. There was 0.85% RBC lysis, an approximately 20% decrease in percentage oxyhemoglobin, and a 14% increase in methemoglobin formation, which shows hemoglobin oxidation on day 28.
Conclusions
Oxidative damage to RBC, with an increase in storage time was observed in the present study. The observed morphological changes to RBC during the course of increased time shows that there is progressive damage to RBC membrane and a decrease in hemoglobin concentration; percentage RBC lysis is probably due to free hemoglobin and iron.
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Affiliation(s)
- Ibrahim Mustafa
- Department of Biomedical Science, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Tameem Ali Qaid Hadwan
- Department of Biomedical Science, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
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Mykhailova O, Olafson C, Turner TR, DʼAlessandro A, Acker JP. Donor-dependent aging of young and old red blood cell subpopulations: Metabolic and functional heterogeneity. Transfusion 2020; 60:2633-2646. [PMID: 32812244 DOI: 10.1111/trf.16017] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/08/2020] [Accepted: 07/08/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Characteristics of red blood cells (RBCs) are influenced by donor variability. This study assessed quality and metabolomic variables of RBC subpopulations of varied biologic age in red blood cell concentrates (RCCs) from male and female donors to evaluate their contribution to the storage lesion. STUDY DESIGN AND METHODS Red blood cell concentrates from healthy male (n = 6) and female (n = 4) donors were Percoll separated into less dense ("young", Y-RCCs) and dense ("old", O-RCCs) subpopulations, which were assessed weekly for 28 days for changes in hemolysis, mean cell volume (MCV), hemoglobin concentration (MCHC), hemoglobin autofluorescence (HGB), morphology index (MI), oxygen affinity (p50), rigidity, intracellular reactive oxygen species (ROS), calcium ([Ca2+ ]), and mass spectrometry-based metabolomics. RESULTS Young RCCs having disc-to-discoid morphology showed higher MCV and MI, but lower MCHC, HGB, and rigidity than O-RCCs, having discoid-to-spheroid shape. By Day 14, Y-RCCs retained lower hemolysis and rigidity and higher p50 compared to O-RCCs. Donor sex analyses indicated that females had higher MCV, HGB, ROS, and [Ca2+ ] and lower hemolysis than male RBCs, in addition to having a decreased rate of change in hemolysis by Day 28. Metabolic profiling indicated a significant sex-related signature across all groups with increased markers of high membrane lipid remodeling and antioxidant capacity in Y-RCCs, whereas O-RCCs had increased markers of oxidative stress and decreased coping capability. CONCLUSION The structural, functional, and metabolic dissimilarities of Y-RCCs and O-RCCs from female and male donors demonstrate RCC heterogeneity, where RBCs from females contribute less to the storage lesion and age slower than males.
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Affiliation(s)
- Olga Mykhailova
- Centre for Innovation, Canadian Blood Services, Edmonton, Alberta, Canada
| | - Carly Olafson
- Centre for Innovation, Canadian Blood Services, Edmonton, Alberta, Canada
| | - Tracey R Turner
- Centre for Innovation, Canadian Blood Services, Edmonton, Alberta, Canada
| | - Angelo DʼAlessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jason P Acker
- Centre for Innovation, Canadian Blood Services, Edmonton, Alberta, Canada.,Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
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12
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A cross-sectional study of prevalence, distribution, cause, and impact of blood product recalls in the United States. Blood Adv 2020; 4:1780-1791. [PMID: 32343797 DOI: 10.1182/bloodadvances.2019001024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 03/10/2020] [Indexed: 01/28/2023] Open
Abstract
Defective blood products that are recalled because of safety or potency deviations can trigger adverse health events and constrict the nation's blood supply chain. However, the underlying characteristics and impact of blood product recalls are not fully understood. In this study, we identified 4700 recall events, 7 reasons for recall, and 144 346 units affected by recalls. Using geospatial mapping of the newly defined county-level recall event density, we discovered hot spots with high prevalence and likelihood of blood product recall events. Distribution patterns and distribution distances of recalled blood products vary significantly between product types. Blood plasma is the most recalled product (87 980 units), and leukocyte-reduced products (34 230 units) are recalled in larger numbers than non-leukocyte-reduced products (8076 units). Donor-related reasons (92 382 units) and sterility deviations (22 408 units) are the major cause of blood product recalls. Monetary loss resulting from blood product recalls is estimated to be $17.9 million, and economic sensitivity tests show that donor-related reasons and sterility deviations contribute most to the overall monetary burden. A total of 2.8 million days was required to resolve recall events, and probabilistic survival time analysis shows that sterility deviations and contamination took longer to resolve because of their systemic effect on blood collection and processing. Our studies demonstrate that better donor screening procedures, rigorous sterility requirements, improved containment methods, and mitigation of recall events in high-prevalence regions will enable a more robust blood supply chain.
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13
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The Contribution of Storage Medium and Membranes in the Microwave Dielectric Response of Packed Red Blood Cells Suspension. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10051702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
During cold storage, packed red blood cells (PRBCs) undergo slow detrimental changes that are collectively termed storage lesion. The aging of the cells causes alterations in the composition of the storage-medium in the PRBC unit. In this paper, we present the comparison of the dielectric response of water in the primary (fresh) storage medium (citrate phosphate dextrose adenine solution, CPDA-1) versus the storage medium from three expired units of PRBCs. Dielectric response of the water molecules has been characterized by dielectric spectroscopy technique in the microwave frequency band (0.5–40 GHz). The dominant phenomenon is the significant increase of the dielectric strength and decrease the relaxation time τ for the samples of the stored medium in comparison with the fresh medium CPDA-1. Furthermore, we demonstrated that removing the ghosts from PRBC hemolysate did not cause the alteration of the dielectric spectrum of water. Thus, the contribution associated with water located near the cell membrane can be neglected in microwave dielectric measurements.
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14
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Sellberg F, Fredriksson F, Engstrand T, Bowden TM, Nilsson B, Hong J, Knutson F, Berglund D. Polyvinylalcohol-carbazate (PVAC) reduces red blood cell hemolysis. PLoS One 2019; 14:e0225777. [PMID: 31809514 PMCID: PMC6897416 DOI: 10.1371/journal.pone.0225777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 11/12/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The objective of this study was to investigate whether a soluble polymer and aldehyde-scavenger, polyvinylalcohol-carbazate (PVAC), can inhibit hemolysis in the storage of red blood cells (RBC). STUDY DESIGN AND METHODS The effect of PVAC was assessed over a wide range of concentrations, using absorption spectroscopy to evaluate the level of hemolysis. Moreover, osmotic stability and aldehyde-scavenging potential of RBC were assessed after storage in PVAC. RESULTS After test tube storage for two weeks, red blood cell hemolysis was lower with PVAC compared to controls (mean difference 23%, 95% CI 16-29%, p < 0.001). A higher level of hemolysis led to a pronounced effect with PVAC. RBC stored in PVAC improved both the binding of free aldehydes (p <0.001) and the osmotic stability (p = 0.0036). CONCLUSION Erythrocytes stored with PVAC showed less hemolysis, which might be explained by the ability of PVACs to stabilize the cell membrane and decrease oxidative injury.
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Affiliation(s)
- Felix Sellberg
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Fanny Fredriksson
- Department of Women’s and Children’s Health, Section of Pediatric Surgery, Uppsala University, Uppsala, Sweden
| | - Thomas Engstrand
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Tim Melander Bowden
- Department of Chemistry—Ångström Laboratory, Uppsala University, Uppsala, Sweden
| | - Bo Nilsson
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Jaan Hong
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Folke Knutson
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - David Berglund
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
- * E-mail:
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15
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Patel RM, Josephson CD, Shenvi N, Maheshwari A, Easley KA, Stowell S, Sola-Visner M, Ferrer-Marin F. Platelet transfusions and mortality in necrotizing enterocolitis. Transfusion 2018; 59:981-988. [PMID: 30597571 DOI: 10.1111/trf.15112] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 11/07/2018] [Accepted: 11/08/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Prior studies have suggested an association between platelet transfusions (PTXs) and worse outcomes among infants with necrotizing enterocolitis (NEC), potentially mediated by proinflammatory factors released by platelets. However, the effects of storage on platelet proinflammatory factor release and the confounding role of illness severity on NEC outcomes have not been determined. STUDY DESIGN AND METHODS First, neuropeptide Y (a potent splanchnic vasoconstrictor released by platelets) was measured by enzyme-linked immunosorbent assay in fresh frozen plasma and in the supernatant of leukoreduced apheresis-derived platelets at different times during storage. Next, we evaluated the relationship between PTX rates and death in a multicenter cohort of very-low-birth-weight infants with NEC, adjusting for illness severity. RESULTS Neuropeptide Y levels increased over time in the supernatant of leukoreduced apheresis-derived platelets and were 4.4-fold and 8.9-fold higher than in fresh frozen plasma on Days 2 and 3 of storage, respectively (p < 0.001). Among 598 very-low-birth-weight infants, 44 developed NEC. In unadjusted analysis, PTX rate was 30.3 (95% confidence interval [CI], 11.5-80.1) per 100 infant-days among infants who died, compared to 6.0 (95% CI, 3.2-11.2) among survivors (incidence rate ratio, 5.1; 95% CI, 1.6-16.2; p = 0.006). In multivariable analysis, there was no association between PTX rate and mortality (incidence rate ratio, 3.0; 95% CI, 0.6-15.0; p = 0.18), although estimation was imprecise. CONCLUSION Proinflammatory mediators accumulate in platelet suspensions during storage. Although PTX rates were not associated with increased mortality among infants with NEC in our study, our estimates suggest the potential for such an association that needs evaluation in larger studies.
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Affiliation(s)
- Ravi M Patel
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.,Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Cassandra D Josephson
- Children's Healthcare of Atlanta, Atlanta, Georgia.,Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia
| | - Neeta Shenvi
- Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Akhil Maheshwari
- Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Kirk A Easley
- Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Sean Stowell
- Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia
| | - Martha Sola-Visner
- Division of Newborn Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Francisca Ferrer-Marin
- Division of Newborn Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.,Unidad de Hematología y Oncología Médica, Hospital Universitario Morales-Meseguer, Centro de Hemodonacion, IMIB-Arrixaca, CIBERER, UCAM, Murcia, Spain
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16
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Preoperative anemia and perioperative blood transfusion in head and neck squamous cell carcinoma. PLoS One 2018; 13:e0205712. [PMID: 30347001 PMCID: PMC6197687 DOI: 10.1371/journal.pone.0205712] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/01/2018] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES To evaluate the impact of preoperative anemia and perioperative blood transfusion (PBT) on disease free (DFS) and overall survival (OS) of patients with head and neck squamous cell carcinoma (HNSCC). METHODS Retrospective study of 354 patients primarily treated with surgery between 2006 and 2016. Cases were selected according to completeness and accuracy of available clinical data. Thus, a selection bias cannot be excluded. Patients who received PBT were identified by our controlling department and verified by our blood bank data base. RESULTS Both, preoperative anemia and PBT significantly decreased OS in univariate analysis. Although PBT was needed more frequently by older patients in worse physical conditions with more advanced HNSCC, subgroup analysis also demonstrate a profoundly negative effect of PBT on OS in younger patients and early stage HNSCC. According to a restrictive transfusion policy at our hospital the transfusion rate was comparably low. We could not verify increasing effects of PBT on cancer recurrence rates as it was previously shown. DISCUSSION Preoperative anemia is the most common paraneoplastic syndrome in HNSCC. Despite its devastating prognostic effect we suggest a restrictive transfusion policy whenever possible. Our data also show that anemia as an independent prognostic factor in head and neck surgical oncology is defined not only by low hemoglobin concentrations but low red blood cell counts as well.
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17
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Remy KE, Hall MW, Cholette J, Juffermans NP, Nicol K, Doctor A, Blumberg N, Spinella PC, Norris PJ, Dahmer MK, Muszynski JA. Mechanisms of red blood cell transfusion-related immunomodulation. Transfusion 2018; 58:804-815. [PMID: 29383722 DOI: 10.1111/trf.14488] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 11/13/2017] [Accepted: 12/10/2017] [Indexed: 01/28/2023]
Abstract
Red blood cell (RBC) transfusion is common in critically ill, postsurgical, and posttrauma patients in whom both systemic inflammation and immune suppression are associated with adverse outcomes. RBC products contain a multitude of immunomodulatory mediators that interact with and alter immune cell function. These interactions can lead to both proinflammatory and immunosuppressive effects. Defining clinical outcomes related to immunomodulatory effects of RBCs in transfused patients remains a challenge, likely due to complex interactions between individual blood product characteristics and patient-specific risk factors. Unpacking these complexities requires an in-depth understanding of the mechanisms of immunomodulatory effects of RBC products. In this review, we outline and classify potential mediators of RBC transfusion-related immunomodulation and provide suggestions for future research directions.
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Affiliation(s)
- Kenneth E Remy
- Department of Pediatrics, Division of Pediatric Critical Care, Washington University School of Medicine, St Louis, Missouri
| | - Mark W Hall
- Division of Critical Care Medicine, Nationwide Children's Hospital, Columbus, Ohio.,The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Jill Cholette
- Pediatric Critical Care and Cardiology, University of Rochester, Rochester, New York
| | - Nicole P Juffermans
- Department of Intensive Care Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Kathleen Nicol
- Department of Pathology, Nationwide Children's Hospital, Columbus, Ohio
| | - Allan Doctor
- Department of Pediatrics, Division of Pediatric Critical Care, Washington University School of Medicine, St Louis, Missouri
| | - Neil Blumberg
- Transfusion Medicine/Blood Bank and Clinical Laboratories, Departments of Pathology and Laboratory Medicine, University of Rochester, Rochester, New York
| | - Philip C Spinella
- Department of Pediatrics, Division of Pediatric Critical Care, Washington University School of Medicine, St Louis, Missouri
| | - Philip J Norris
- Blood Systems Research Institute, San Francisco, California.,Departments of Laboratory Medicine and Medicine, University of California at San Francisco, San Francisco, California
| | - Mary K Dahmer
- Department of Pediatrics, Division of Pediatric Critical Care, University of Michigan, Ann Arbor, Michigan
| | - Jennifer A Muszynski
- Division of Critical Care Medicine, Nationwide Children's Hospital, Columbus, Ohio.,The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
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18
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Chang CC, Lee TC, Su MJ, Lin HC, Cheng FY, Chen YT, Yen TH, Chu FY. Transfusion-associated adverse reactions (TAARs) and cytokine accumulations in the stored blood components: the impact of prestorage versus poststorage leukoreduction. Oncotarget 2017; 9:4385-4394. [PMID: 29435110 PMCID: PMC5796981 DOI: 10.18632/oncotarget.23136] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 11/13/2017] [Indexed: 01/08/2023] Open
Abstract
Leukoreduction in blood units could prevent patients undergoing transfusions from transfusion-associated adverse reactions (TAARs) such as febrile nonhemolytic transfusion reactions (FNHTRs). However, the effect of prestorage and poststorage leukoreduction on TAARs and its underlying mechanisms in stored blood components remains to be determined. Therefore, we investigated the impact of prestorage leukocyte-reduced (pre-LR) and poststorage leukocyte-reduced (post-LR) blood products, including red blood cells (RBCs) and apheresis platelets (PHs), on the incidence of FNHTRs and other TAARs in patients who received transfusions from 2009 to 2014 in a tertiary care center. We also investigated the difference of leukocyte-related bioactive mediators between pre- and post-LR blood components. The results indicated that prevalence of TAARs was significantly reduced in the transfusions of pre-LR blood components. Particularly, the prevalence of FNHTRs was significantly reduced in the pre-LR RBC transfusions and the prevalence of allergy reactions was markedly reduced in the pre-LR PH transfusions. Furthermore, in vitro evaluation of cytokines in the pre- and post-LR blood components revealed that IL-1β, IL-8 and RANTES levels were significantly elevated in the post-LR RBCs during the storage. In contrast, IL-1β, IL-6 and IL-8 levels were significantly elevated in the post-LR PHs during the storage. These findings suggested that prestorage leukoreduction had a diminishing effect on the development of TAARs, which could be associated with less accumulation of cytokines in the stored blood components.
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Affiliation(s)
- Chih-Chun Chang
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Tai-Chen Lee
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Ming-Jang Su
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Hsiu-Chen Lin
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Fang-Yi Cheng
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Yi-Ting Chen
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Tzung-Hai Yen
- Department of Nephrology and Division of Clinical Toxicology and Toxicology Laboratory, Chang Gung Memorial Hospital, Lin-Kou Medical Center, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Fang-Yeh Chu
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan.,School of Medical Laboratory Science and Biotechnology, Taipei Medical University, Taipei, Taiwan.,Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan.,Department of Medical Laboratory Science and Biotechnology, Yuanpei University, Hsinchu, Taiwan
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19
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Nemkov T, Sun K, Reisz JA, Song A, Yoshida T, Dunham A, Wither MJ, Francis RO, Roach RC, Dzieciatkowska M, Rogers SC, Doctor A, Kriebardis A, Antonelou M, Papassideri I, Young CT, Thomas TA, Hansen KC, Spitalnik SL, Xia Y, Zimring JC, Hod EA, D'Alessandro A. Hypoxia modulates the purine salvage pathway and decreases red blood cell and supernatant levels of hypoxanthine during refrigerated storage. Haematologica 2017; 103:361-372. [PMID: 29079593 PMCID: PMC5792281 DOI: 10.3324/haematol.2017.178608] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 10/24/2017] [Indexed: 12/18/2022] Open
Abstract
Hypoxanthine catabolism in vivo is potentially dangerous as it fuels production of urate and, most importantly, hydrogen peroxide. However, it is unclear whether accumulation of intracellular and supernatant hypoxanthine in stored red blood cell units is clinically relevant for transfused recipients. Leukoreduced red blood cells from glucose-6-phosphate dehydrogenase-normal or -deficient human volunteers were stored in AS-3 under normoxic, hyperoxic, or hypoxic conditions (with oxygen saturation ranging from <3% to >95%). Red blood cells from healthy human volunteers were also collected at sea level or after 1–7 days at high altitude (>5000 m). Finally, C57BL/6J mouse red blood cells were incubated in vitro with 13C1-aspartate or 13C5-adenosine under normoxic or hypoxic conditions, with or without deoxycoformycin, a purine deaminase inhibitor. Metabolomics analyses were performed on human and mouse red blood cells stored for up to 42 or 14 days, respectively, and correlated with 24 h post-transfusion red blood cell recovery. Hypoxanthine increased in stored red blood cell units as a function of oxygen levels. Stored red blood cells from human glucose-6-phosphate dehydrogenase-deficient donors had higher levels of deaminated purines. Hypoxia in vitro and in vivo decreased purine oxidation and enhanced purine salvage reactions in human and mouse red blood cells, which was partly explained by decreased adenosine monophosphate deaminase activity. In addition, hypoxanthine levels negatively correlated with post-transfusion red blood cell recovery in mice and – preliminarily albeit significantly - in humans. In conclusion, hypoxanthine is an in vitro metabolic marker of the red blood cell storage lesion that negatively correlates with post-transfusion recovery in vivo. Storage-dependent hypoxanthine accumulation is ameliorated by hypoxia-induced decreases in purine deamination reaction rates.
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Affiliation(s)
- Travis Nemkov
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver - Anschutz Medical Campus, Aurora, CO, USA
| | - Kaiqi Sun
- Department of Biochemistry, University of Texas Houston - School of Medicine, Houston, TX, USA
| | - Julie A Reisz
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver - Anschutz Medical Campus, Aurora, CO, USA
| | - Anren Song
- Department of Biochemistry, University of Texas Houston - School of Medicine, Houston, TX, USA
| | | | | | - Matthew J Wither
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver - Anschutz Medical Campus, Aurora, CO, USA
| | - Richard O Francis
- Department of Pathology & Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Robert C Roach
- Altitude Research Center, University of Colorado Denver - Anschutz Medical Campus, Aurora, CO, USA
| | - Monika Dzieciatkowska
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver - Anschutz Medical Campus, Aurora, CO, USA
| | - Stephen C Rogers
- Division of Critical Care Medicine, Department of Pediatrics, School of Medicine, Washington University in St Louis, St Louis, MO, USA
| | - Allan Doctor
- Division of Critical Care Medicine, Department of Pediatrics, School of Medicine, Washington University in St Louis, St Louis, MO, USA
| | - Anastasios Kriebardis
- Department of Medical Laboratories, Technological and Educational Institute of Athens, Greece
| | - Marianna Antonelou
- Department of Biology, National and Kapodistrian University of Athens, Greece
| | | | | | - Tiffany A Thomas
- Department of Pathology & Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Kirk C Hansen
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver - Anschutz Medical Campus, Aurora, CO, USA
| | - Steven L Spitalnik
- Department of Pathology & Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Yang Xia
- Department of Biochemistry, University of Texas Houston - School of Medicine, Houston, TX, USA
| | | | - Eldad A Hod
- Department of Pathology & Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Angelo D'Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver - Anschutz Medical Campus, Aurora, CO, USA .,Boettcher Investigator
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20
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Garraud O. Effect of "old" versus "fresh" transfused red blood cells on patients' outcome: probably more complex than appears. J Thorac Dis 2017; 9:E146-E148. [PMID: 28275500 DOI: 10.21037/jtd.2017.02.03] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Olivier Garraud
- EA3064, Faculty of medicine of Saint-Etienne, University of Lyon, 42023 Saint-Etienne, France; ; National Institute of Blood Transfusion, 75015 Paris, France
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