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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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Radulescu SM, Skulberg R, McDonald C, Chan DL, Humm K. Randomized double-blinded clinical trial on acute transfusion reactions in dogs receiving leukoreduced versus nonleukoreduced packed red blood cells. J Vet Intern Med 2021; 35:1325-1332. [PMID: 33960540 PMCID: PMC8162603 DOI: 10.1111/jvim.16138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/09/2021] [Accepted: 04/15/2021] [Indexed: 12/14/2022] Open
Abstract
Background Leukoreduction of blood products is commonly performed in human medicine, but its effect on outcome or incidence of transfusion reactions (TRs) in dogs is unknown. Objectives To prospectively evaluate the incidence of acute TRs in, and the outcome of, dogs receiving either leukoreduced (LR) or nonleukoreduced (N‐LR) packed red blood cells (PRBC). Animals Dogs (n = 194) administered PRBC between August 2017 and June 2020. Methods Prospective randomized double‐blinded clinical trial. Dogs were randomized to receive either LR or N‐LR PRBC and clinicians, nurses and investigators were blinded to the group allocations. The incidence of TRs, change in PCV, hospitalization duration, and survival to discharge were recorded. Results Out of the 194 dogs, 96 received LR and 98 received N‐LR PRBCs. The mean 12‐hour change in PCV value was +9.22% (SD 5.27%) for dogs that received N‐LR and +10.69% (SD 6.44%) for dogs that received LR PRBC (effect size 0.26, 95% confidence interval [CI] −0.02 to 0.55), which was not significantly different (P = .08). TRs were documented in 16/194 (8.24%) dogs, with 1/194 (0.51%) being a mild allergic reaction, while 15/194 (7.73%) had suspected febrile nonhemolytic TRs (FNHTRs). FNHTR incidence was not significantly different between the LR (6/96, 6.25%, 95% CI 2.8‐13.56) and N‐LR (9/98, 9.18%, 95% CI 4.92‐17.11) groups (P = .81). Of the 156 dogs that survived to discharge, 80/156 received N‐LR PRBC and 76/156 received LR PRBC which was not significantly different (P = .66). Conclusions and Clinical Importance A clinical advantage of using LR over N‐LR PRBC in terms of TRs and increase in PCV after transfusion was not detected.
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Affiliation(s)
- Sinziana Maria Radulescu
- Department of Clinical Sciences and Services, The Royal Veterinary College, North Mymms, Herts, United Kingdom
| | - Ragnhild Skulberg
- Department of Clinical Sciences and Services, The Royal Veterinary College, North Mymms, Herts, United Kingdom.,Small Animal Section, Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Ås, Norway
| | - Charlotte McDonald
- Department of Clinical Sciences and Services, The Royal Veterinary College, North Mymms, Herts, United Kingdom.,Dick White Referrals, Station Farm, Cambridgeshire, United Kingdom
| | - Daniel L Chan
- Department of Clinical Sciences and Services, The Royal Veterinary College, North Mymms, Herts, United Kingdom
| | - Karen Humm
- Department of Clinical Sciences and Services, The Royal Veterinary College, North Mymms, Herts, United Kingdom
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Antognoni MT, Marenzoni ML, Misia AL, Avellini L, Chiaradia E, Gavazza A, Miglio A. Effect of Leukoreduction on Hematobiochemical Parameters and Storage Hemolysis in Canine Whole Blood Units. Animals (Basel) 2021; 11:ani11040925. [PMID: 33805143 PMCID: PMC8064101 DOI: 10.3390/ani11040925] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 01/28/2023] Open
Abstract
Simple Summary During the storage of blood units, cells undergo many changes, defined as storage lesions; these are biochemical, morphological and immunological modifications and seem to be responsible for adverse post-transfusion effects in recipients. The pre-storage leukoreduction seems to reduce them. The aims of this study are both to evaluate the human filter effectiveness and the effect of pre-storage leukoreduction in stored canine whole blood units. We tested whole blood units, leukoreduced and not, obtained from seven enrolled subjects, until the 42nd day. The white blood cell (WBC) and platelet (PLT) counts are reported to express the leukoreduction effectiveness. As indicators of storage-induced hemolysis, the lactate dehydrogenase activity (LDH) and sodium, potassium, and chlorine electrolytes were measured in plasma, and the red blood cell (RBC) count, hemoglobin concentration (Hgb), and hematocrit (Hct) were obtained with the complete blood count (CBC). The mean corpuscular volume (MCV) values and morphological index obtained from blood smear evaluation were used as indices of morphological changes. We observed that the leukoreduction filter for human use is equally effective on canine whole blood and that leukoreduction has a partially protective role to prevent some storage lesions. Abstract Storage lesions (SLs) occur when the red blood cell quality is altered during the preservation of blood units. Pre-storage leukoreduction would limit the number of SLs. The aims of this study were to evaluate the effectiveness of a leukoreduction filter for human use and the effect of pre-storage leukoreduction on some ematobiochemical parameters in stored canine whole blood. Seven canine blood units were tested. Each one was divided into two units—one leukoreduced (LRWB) and one non-leukoreduced (nLRWB). On each unit, we determined the complete blood count (CBC), lactate-dehydrogenase (LDH), electrolytes (Na+, K+, Cl−), morphological index (MI) and hemolysis, on storage days 0, 7, 14, 21, 28, 35, and 42. Leukoreduction allowed a 98.30% recovery of the RBC count, retaining 99.69% and 94.91% of WBCs and PLTs, respectively. We detected a significant increase of LDH and MI with strongly higher values in nLRWB compared to LRWB. A progressive increase in electrolytes and LDH concentrations was observed as indices of stored hemolysis. LDH showed significantly lower values in LRWB units compared to nLRWB, suggesting its release from leukocytes. In the majority of units, hemolysis reached 1% on the 42nd day of storage. We assert the human leukoreduction filter effectiveness on canine whole blood, and we recommend using nLRWB before day 14, especially for critically ill patients. The difference of the basal hemolysis (day 0) percentages observed between subjects suggests that more studies should be performed to confirm a possible inter-individual donor biological variability of RBC membrane resistance, as happens in humans.
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Affiliation(s)
- Maria Teresa Antognoni
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (M.T.A.); (M.L.M.); (A.L.M.); (L.A.); (E.C.)
| | - Maria Luisa Marenzoni
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (M.T.A.); (M.L.M.); (A.L.M.); (L.A.); (E.C.)
| | - Ambra Lisa Misia
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (M.T.A.); (M.L.M.); (A.L.M.); (L.A.); (E.C.)
| | - Luca Avellini
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (M.T.A.); (M.L.M.); (A.L.M.); (L.A.); (E.C.)
| | - Elisabetta Chiaradia
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (M.T.A.); (M.L.M.); (A.L.M.); (L.A.); (E.C.)
| | - Alessandra Gavazza
- School of Bioscences and Veterinary Medicine, University of Camerino, 62024 Camerino, Italy;
| | - Arianna Miglio
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (M.T.A.); (M.L.M.); (A.L.M.); (L.A.); (E.C.)
- Correspondence:
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Avenick D, Kidd L, Istvan S, Dong F, Richter K, Edwards N, Hisada Y, Posma JJN, Massih CA, Mackman N. Effects of storage and leukocyte reduction on the concentration and procoagulant activity of extracellular vesicles in canine packed red cells. J Vet Emerg Crit Care (San Antonio) 2021; 31:221-230. [PMID: 33751799 DOI: 10.1111/vec.13050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 06/01/2019] [Accepted: 06/24/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To characterize the size and procoagulant activity of extracellular vesicles (EV) that accumulate in canine packed red blood cells (pRBCs) over time and the effect of leukocyte reduction on these characteristics. DESIGN Prospective cohort study. SETTING Private small animal specialty referral hospital and university research laboratories. ANIMALS Ten healthy blood donor dogs. INTERVENTIONS Five pRBCs units were obtained according to standard protocols, and 5 were leukocyte-reduced prior to processing. Platelet-free supernatant from the pRBC units was collected on days 0, 10, 20, 32, and 42. MEASUREMENTS AND MAIN RESULTS Nanoparticle tracking analysis was performed to determine the size and concentration of EVs. Thrombin generation associated with phosphatidylserine-positive EVs was determined using a capture assay. Factor Xa generation associated with phosphatidylserine-positive EVs and tissue factor-positive EVs was measured in a subset of EVs isolated by centrifugation of the supernatant at 20,000 × g. R package nparLD and the Mann-Whitney U-test were used to determine the effect of duration of storage and the effect of leukocyte reduction, respectively. Small (mean < 125 nm) procoagulant EVs accumulated over time, with significant increases occurring on or after day 20 in both non-leukocyte reduced and leukocyte-reduced units. The procoagulant activity of the EVs was due to phosphatidylserine, not tissue factor. Increases in EV concentration and procoagulant activity occurred earlier in non-leukocyte reduced units. Extracellular vesicle accumulation and procoagulant activity were not decreased at any individual time point by leukocyte reduction. CONCLUSIONS Further studies characterizing and determining the clinical relevance of small procoagulant EVs in pRBCs are warranted.
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Affiliation(s)
| | - Linda Kidd
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, California
| | | | - Fanglong Dong
- Graduate College of Biomedical Sciences, Western University of Health Sciences, Pomona, California
| | - Keith Richter
- Veterinary Specialty Hospital, San Diego, California
| | | | - Yohei Hisada
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jens J N Posma
- Departments of Internal Medicine and Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Cherein Abdel Massih
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, California
| | - Nigel Mackman
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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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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