1
|
Obonyo NG, Sela DP, White N, Tunbridge M, Sim B, Rachakonda RH, See Hoe LE, Li Bassi G, Fanning JP, Tung JP, Suen JY, Fraser JF. Effects of transfusing older red blood cells on patient outcomes in critical illness: A retrospective cohort study. Vox Sang 2025; 120:481-489. [PMID: 40031908 DOI: 10.1111/vox.70007] [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: 09/12/2024] [Revised: 01/20/2025] [Accepted: 02/13/2025] [Indexed: 03/05/2025]
Abstract
BACKGROUND AND OBJECTIVES Randomized controlled trials have demonstrated morbidity and mortality in critically ill patients are unaffected by transfusing fresh (<7 days old) packed red blood cells (pRBCs); however, there is limited evidence regarding transfusion with pRBCs nearing expiry (35-42 days). The aim of this study was to investigate the effects of transfusing pRBCs close to the end of shelf life (≥35 days) on clinical outcomes in critically ill patients. MATERIALS AND METHODS A retrospective observational analysis of data obtained from centralized electronic medical records (2007-2013), sourced from all public and licensed private hospitals in Queensland, Australia, with intensive care units. Multivariate logistic and linear regressions were used to analyse association between transfusion with pRBCs nearing expiry, and in-hospital mortality, hospital length of stay (HLOS) and rate of discharge home. Comparisons are presented as odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS The study included 10,350 critically ill adult patients transfused ≥1 unit of non-irradiated pRBCs (64,594 pRBCs units transfused). Receiving at least 1-unit pRBCs ≥ 35 days old was associated with increased mortality (OR 1.21 [95% CI 1.06-1.38]; p = 0.005), decreased discharge to usual residence (OR 0.81 [95% CI 0.73-0.89]; p < 0.0001) and increased hospital LOS (estimate 2.55 [95% CI 1.60-3.49]; p < 0.0001). There was also association with increased sepsis (OR 1.27 [95% CI 1.13-1.42]; p < 0.0001) and delirium (OR 1.25 [95% CI 1.06-1.49]; p = 0.01). CONCLUSION Transfusion of ≥1-unit pRBCs ≥ 35 days old was associated with higher morbidity and mortality in critically ill patients.
Collapse
Affiliation(s)
- Nchafatso G Obonyo
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- Initiative to Develop African Research Leaders (IDeAL)/KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Wellcome Trust Centre for Global Health Research, Imperial College London, London, UK
- Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Declan P Sela
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Nicole White
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Matthew Tunbridge
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Beatrice Sim
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Reema H Rachakonda
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Louise E See Hoe
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Gianluigi Li Bassi
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Wesley Medical Research, The Wesley Foundation, Brisbane, Queensland, Australia
- Intensive Care Unit, St Andrew's War Memorial Hospital, Brisbane, Queensland, Australia
- Intensive Care Unit, The Wesley Hospital, Brisbane, Queensland, Australia
| | - Jonathon P Fanning
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - John-Paul Tung
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Clinical Services and Research, Australian Red Cross Lifeblood, Brisbane, Queensland, Australia
| | - Jacky Y Suen
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - John F Fraser
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Intensive Care Unit, St Andrew's War Memorial Hospital, Brisbane, Queensland, Australia
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| |
Collapse
|
2
|
Prudent M. How to digest gargantuan data on red cell aging. Blood 2024; 143:2448-2449. [PMID: 38869915 DOI: 10.1182/blood.2024024679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Affiliation(s)
- Michel Prudent
- Transfusion Interrégionale Croix-Rouge Suisse, Lausanne University Hospital, University of Lausanne, and University of Geneva
| |
Collapse
|
3
|
Mikhailova DM, Skverchinskaya E, Sudnitsyna J, Butov KR, Koltsova EM, Mindukshev IV, Gambaryan S. Hematin- and Hemin-Induced Spherization and Hemolysis of Human Erythrocytes Are Independent of Extracellular Calcium Concentration. Cells 2024; 13:554. [PMID: 38534398 PMCID: PMC10969559 DOI: 10.3390/cells13060554] [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: 02/12/2024] [Revised: 03/10/2024] [Accepted: 03/15/2024] [Indexed: 03/28/2024] Open
Abstract
Pathologies such as malaria, hemorrhagic stroke, sickle cell disease, and thalassemia are characterized by the release of hemoglobin degradation products from damaged RBCs. Hematin (liganded with OH-) and hemin (liganded with Cl-)-are the oxidized forms of heme with toxic properties due to their hydrophobicity and the presence of redox-active Fe3. In the present study, using the original LaSca-TM laser particle analyzer, flow cytometry, and confocal microscopy, we showed that both hematin and hemin induce dose-dependent RBC spherization and hemolysis with ghost formation. Hematin and hemin at nanomolar concentrations increased [Ca2+]i in RBC; however, spherization and hemolysis occurred in the presence and absence of calcium, indicating that both processes are independent of [Ca2+]i. Both compounds triggered acute phosphatidylserine exposure on the membrane surface, reversible after 60 min of incubation. A comparison of hematin and hemin effects on RBCs revealed that hematin is a more reactive toxic metabolite than hemin towards human RBCs. The toxic effects of heme derivatives were reduced and even reversed in the presence of albumin, indicating the presence in RBCs of the own recovery system against the toxic effects of heme derivatives.
Collapse
Affiliation(s)
- Diana M. Mikhailova
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, 44 Thorez Ave., 194223 Saint Petersburg, Russia; (D.M.M.); (E.S.); (J.S.); (I.V.M.)
- Department of Cytology and Histology, Saint Petersburg State University, 7/9 Universitetskaya Emb., 199034 Saint Petersburg, Russia
| | - Elisaveta Skverchinskaya
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, 44 Thorez Ave., 194223 Saint Petersburg, Russia; (D.M.M.); (E.S.); (J.S.); (I.V.M.)
| | - Julia Sudnitsyna
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, 44 Thorez Ave., 194223 Saint Petersburg, Russia; (D.M.M.); (E.S.); (J.S.); (I.V.M.)
| | - Kirill R. Butov
- Department of Molecular Biology and Medical Biotechnology, Pirogov Russian National Research Medical University, 117997 Moscow, Russia;
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, 117997 Moscow, Russia;
| | - Ekaterina M. Koltsova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, 117997 Moscow, Russia;
- Center for Theoretical Problems of Physicochemical Pharmacology, Russian Academy of Sciences, 30 Srednyaya Kalitnikovskaya st., 109029 Moscow, Russia
| | - Igor V. Mindukshev
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, 44 Thorez Ave., 194223 Saint Petersburg, Russia; (D.M.M.); (E.S.); (J.S.); (I.V.M.)
| | - Stepan Gambaryan
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, 44 Thorez Ave., 194223 Saint Petersburg, Russia; (D.M.M.); (E.S.); (J.S.); (I.V.M.)
| |
Collapse
|
4
|
Bardyn M, Crettaz D, Rappaz B, Hamelin R, Armand F, Tissot JD, Turcatti G, Prudent M. Phosphoproteomics and morphology of stored human red blood cells treated by protein tyrosine phosphatases inhibitor. Blood Adv 2024; 8:1-13. [PMID: 37910801 PMCID: PMC10784683 DOI: 10.1182/bloodadvances.2023009964] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 10/17/2023] [Accepted: 10/24/2023] [Indexed: 11/03/2023] Open
Abstract
ABSTRACT The process of protein phosphorylation is involved in numerous cell functions. In particular, phosphotyrosine (pY) has been reported to play a role in red blood cell (RBC) functions, including the cytoskeleton organization. During their storage before transfusion, RBCs suffer from storage lesions that affect their energy metabolism and morphology. This study investigated the relationship between pY and the storage lesions. To do so, RBCs were treated (in the absence of calcium) with a protein tyrosine phosphatase inhibitor (orthovanadate [OV]) to stimulate phosphorylation and with 3 selective kinase inhibitors (KIs). Erythrocyte membrane proteins were studied by western blot analyses and phosphoproteomics (data are available via ProteomeXchange with identifier PXD039914) and cell morphology by digital holographic microscopy. The increase of pY triggered by OV treatment (inducing a global downregulation of pS and pT) disappeared during the storage. Phosphoproteomic analysis identified 609 phosphoproteins containing 1752 phosphosites, of which 41 pY were upregulated and 2 downregulated by OV. After these phosphorylation processes, the shape of RBCs shifted from discocytes to spherocytes, and the addition of KIs partially inhibited this transition. The KIs modulated either pY or pS and pT via diverse mechanisms related to cell shape, thereby affecting RBC morphology. The capacity of RBCs to maintain their function is central in transfusion medicine, and the presented results contribute to a better understanding of RBC biology.
Collapse
Affiliation(s)
- Manon Bardyn
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - David Crettaz
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - Benjamin Rappaz
- Biomolecular Screening Facility, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Romain Hamelin
- Proteomics Core Facility, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Florence Armand
- Proteomics Core Facility, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Jean-Daniel Tissot
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - Gerardo Turcatti
- Biomolecular Screening Facility, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Michel Prudent
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
- Center for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| |
Collapse
|
5
|
Valk SJ, Caram-Deelder C, Evers D, de Vooght KMK, van de Kerkhof D, Wondergem MJ, Péquériaux NCV, Hudig F, Zwaginga JJ, de Korte D, van de Watering LMG, Middelburg RA, van der Bom JG. Donor pregnancies and transfusion recipient mortality: A role for red blood cell storage? Vox Sang 2024; 119:43-52. [PMID: 37920882 DOI: 10.1111/vox.13551] [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: 04/13/2023] [Revised: 09/01/2023] [Accepted: 10/08/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Donor characteristics have been implicated in transfusion-related adverse events. Uncertainty remains about whether sex, and specifically pregnancy history of the blood donor, could affect patient outcomes. Whether storage duration of the blood product could be important for patient outcomes has also been investigated, and a small detrimental effect of fresh products remains a possibility. Here, we hypothesize that fresh red blood cell products donated by ever-pregnant donors are associated with mortality in male patients. MATERIALS AND METHODS We used data from a cohort study of adult patients receiving a first transfusion between 2005 and 2015 in the Netherlands. The risk of death after receiving a transfusion from one of five exposure categories (female never-pregnant stored ≤10 days, female never-pregnant stored >10 days, female ever-pregnant stored ≤10 days, female ever-pregnant stored >10 days and male stored for ≤10 days), compared to receiving a unit donated by a male donor, which was stored for >10 days (reference), was calculated using a Cox proportional hazards model. RESULTS The study included 42,456 patients who contributed 88,538 person-years in total, of whom 13,948 died during the follow-up of the study (33%). Fresh units (stored for ≤10 days) from ever-pregnant donors were associated with mortality in male patients, but the association was not statistically significant (hazard ratio 1.39, 95% confidence interval 0.97-1.99). Sensitivity analyses did not corroborate this finding. CONCLUSION These findings do not consistently support the notion that the observed association between ever-pregnant donor units and mortality is mediated by blood product storage.
Collapse
Affiliation(s)
- Sarah J Valk
- Jon J van Rood Center for Clinical Transfusion Research, Sanquin/LUMC, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Camila Caram-Deelder
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Dorothea Evers
- Department of Haematology, Radboudumc, Nijmegen, The Netherlands
| | - Karen M K de Vooght
- Central Diagnostic Laboratory, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Daan van de Kerkhof
- Department of Clinical Chemistry and Haematology, Catharina Hospital, Eindhoven, The Netherlands
| | - Marielle J Wondergem
- Department of Haematology, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Nathalie C V Péquériaux
- Department of Clinical Chemistry and Haematology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | | | - Jaap Jan Zwaginga
- Jon J van Rood Center for Clinical Transfusion Research, Sanquin/LUMC, Leiden, The Netherlands
- Department of Haematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Dirk de Korte
- Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, The Netherlands
- Department of Blood Cell Research, Sanquin Research, and Landsteiner Laboratory, University of Amsterdam, Amsterdam, The Netherlands
| | - Leo M G van de Watering
- Jon J van Rood Center for Clinical Transfusion Research, Sanquin/LUMC, Leiden, The Netherlands
- Department of Transfusion Medicine, Sanquin Blood Bank, Amsterdam, The Netherlands
| | - Rutger A Middelburg
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Johanna G van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
6
|
Kita VY, Orsi KCSC, de Souza AHP, Tsunemi MH, Avelar AFM. Transfusion Practice: Hemolysis Markers After In Vitro Infusion of Packed Red Blood Cells by the Gravitational Method in Peripheral Catheter. JOURNAL OF INFUSION NURSING 2023; 46:320-331. [PMID: 37920106 DOI: 10.1097/nan.0000000000000521] [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: 11/04/2023]
Abstract
The objective of this study was to compare hemolysis marker levels after in vitro infusion of red blood cells (RBCs) according to storage time, infusion rate, and peripheral intravenous catheter size. This is an experimental study with randomly administered RBCs in quintuplicate, according to storage time shorter than and longer than 14 days, as well as infusion rate (50 mL/h and 100 mL/h) using catheters with calibers of 14-, 18-, and 20-gauge. Aliquots were collected from RBCs (V1), after equipment and catheter (V2) free-flow filling and after controlled infusion through the catheter (V3). The hemolytic markers analyzed were degree of hemolysis (%), hematocrit (Ht) (%), total hemoglobin (THb) (g/dL), free hemoglobin (FHb) (g/dL), potassium (K) (mmol/L), and lactate dehydrogenase (LDH) (U/L), considering a probability of error ≤5%. Sixty experiments were performed with the analysis of 180 aliquots. When RBCs aged <14 days were used, all catheters tended to increase THb, FHb, and K; while >14 days, RBCs presented increased FHb and degree of hemolysis with catheters of 18-gauge and THb levels at 14-gauge. Among the conditions analyzed, only 20-gauge catheters (the smallest) did not influence changes in hemolysis markers, regardless of RBC storage time.
Collapse
Affiliation(s)
- Vanessa Yukie Kita
- Nursing School, Universidade Federal de São Paulo, São Paulo, Brazil (Drs Kita, Orsi, de Souza, and Avelar); Department of Biostatistics, Universidade Estadual Paulista Júlio de Mesquita Filho - Botucatu, São Paulo, Brazil (Dr Tsunemi)
- Vanessa Yukie Kita, RN, MNSc, earned a nursing degree from the Federal University of São Paulo - UNIFESP (2004) and a master of science degree (UNIFESP - 2019). She has experience in the field of nursing, with an emphasis on intensive care. She is currently professor of intensive care at UNIFESP Paulista School of Nursing
- Kelly Cristina Sbampato Calado Orsi, RN, PhD, earned a degree in nursing from the Federal University of São Paulo (2005), as well as a Master of Science (2015) and PhD in sciences at the Escola Paulista de Enfermagem (2019). She is currently professor at the Pediatric Nursing Department at Escola Paulista de Enfermagem/UNIFESP
- Adja Havreluk Paiva de Souza, RN, MNSc, earned a degree in nursing from the Federal University of São Paulo (2005), specialist in emergency nursing degree from the Federal University of São Paulo (2007), and Master of Science (UNIFESP - 2019)
- Miriam Harumi Tsunemi, PhD, earned a degree in statistics from Universidade Estadual Paulista Júlio de Mesquita Filho (2001), a Master's Degree in statistics from the Federal University of São Carlos (2003), and a PhD from the Institute of Mathematics and Statistics of the University of São Paulo
- Ariane Ferreira Machado Avelar, RN, PhD, graduated from the Albert Einstein College of Nursing (1998), earned a Master's Degree in Federal Nursing from São Paulo (2003), and PhD in Sciences at the Federal University of São Paulo (2009). She is currently an associate professor at the Department of Pediatric Nursing (UNIFESP)
| | - Kelly Cristina Sbampato Calado Orsi
- Nursing School, Universidade Federal de São Paulo, São Paulo, Brazil (Drs Kita, Orsi, de Souza, and Avelar); Department of Biostatistics, Universidade Estadual Paulista Júlio de Mesquita Filho - Botucatu, São Paulo, Brazil (Dr Tsunemi)
- Vanessa Yukie Kita, RN, MNSc, earned a nursing degree from the Federal University of São Paulo - UNIFESP (2004) and a master of science degree (UNIFESP - 2019). She has experience in the field of nursing, with an emphasis on intensive care. She is currently professor of intensive care at UNIFESP Paulista School of Nursing
- Kelly Cristina Sbampato Calado Orsi, RN, PhD, earned a degree in nursing from the Federal University of São Paulo (2005), as well as a Master of Science (2015) and PhD in sciences at the Escola Paulista de Enfermagem (2019). She is currently professor at the Pediatric Nursing Department at Escola Paulista de Enfermagem/UNIFESP
- Adja Havreluk Paiva de Souza, RN, MNSc, earned a degree in nursing from the Federal University of São Paulo (2005), specialist in emergency nursing degree from the Federal University of São Paulo (2007), and Master of Science (UNIFESP - 2019)
- Miriam Harumi Tsunemi, PhD, earned a degree in statistics from Universidade Estadual Paulista Júlio de Mesquita Filho (2001), a Master's Degree in statistics from the Federal University of São Carlos (2003), and a PhD from the Institute of Mathematics and Statistics of the University of São Paulo
- Ariane Ferreira Machado Avelar, RN, PhD, graduated from the Albert Einstein College of Nursing (1998), earned a Master's Degree in Federal Nursing from São Paulo (2003), and PhD in Sciences at the Federal University of São Paulo (2009). She is currently an associate professor at the Department of Pediatric Nursing (UNIFESP)
| | - Adja Havreluk Paiva de Souza
- Nursing School, Universidade Federal de São Paulo, São Paulo, Brazil (Drs Kita, Orsi, de Souza, and Avelar); Department of Biostatistics, Universidade Estadual Paulista Júlio de Mesquita Filho - Botucatu, São Paulo, Brazil (Dr Tsunemi)
- Vanessa Yukie Kita, RN, MNSc, earned a nursing degree from the Federal University of São Paulo - UNIFESP (2004) and a master of science degree (UNIFESP - 2019). She has experience in the field of nursing, with an emphasis on intensive care. She is currently professor of intensive care at UNIFESP Paulista School of Nursing
- Kelly Cristina Sbampato Calado Orsi, RN, PhD, earned a degree in nursing from the Federal University of São Paulo (2005), as well as a Master of Science (2015) and PhD in sciences at the Escola Paulista de Enfermagem (2019). She is currently professor at the Pediatric Nursing Department at Escola Paulista de Enfermagem/UNIFESP
- Adja Havreluk Paiva de Souza, RN, MNSc, earned a degree in nursing from the Federal University of São Paulo (2005), specialist in emergency nursing degree from the Federal University of São Paulo (2007), and Master of Science (UNIFESP - 2019)
- Miriam Harumi Tsunemi, PhD, earned a degree in statistics from Universidade Estadual Paulista Júlio de Mesquita Filho (2001), a Master's Degree in statistics from the Federal University of São Carlos (2003), and a PhD from the Institute of Mathematics and Statistics of the University of São Paulo
- Ariane Ferreira Machado Avelar, RN, PhD, graduated from the Albert Einstein College of Nursing (1998), earned a Master's Degree in Federal Nursing from São Paulo (2003), and PhD in Sciences at the Federal University of São Paulo (2009). She is currently an associate professor at the Department of Pediatric Nursing (UNIFESP)
| | - Miriam Harumi Tsunemi
- Nursing School, Universidade Federal de São Paulo, São Paulo, Brazil (Drs Kita, Orsi, de Souza, and Avelar); Department of Biostatistics, Universidade Estadual Paulista Júlio de Mesquita Filho - Botucatu, São Paulo, Brazil (Dr Tsunemi)
- Vanessa Yukie Kita, RN, MNSc, earned a nursing degree from the Federal University of São Paulo - UNIFESP (2004) and a master of science degree (UNIFESP - 2019). She has experience in the field of nursing, with an emphasis on intensive care. She is currently professor of intensive care at UNIFESP Paulista School of Nursing
- Kelly Cristina Sbampato Calado Orsi, RN, PhD, earned a degree in nursing from the Federal University of São Paulo (2005), as well as a Master of Science (2015) and PhD in sciences at the Escola Paulista de Enfermagem (2019). She is currently professor at the Pediatric Nursing Department at Escola Paulista de Enfermagem/UNIFESP
- Adja Havreluk Paiva de Souza, RN, MNSc, earned a degree in nursing from the Federal University of São Paulo (2005), specialist in emergency nursing degree from the Federal University of São Paulo (2007), and Master of Science (UNIFESP - 2019)
- Miriam Harumi Tsunemi, PhD, earned a degree in statistics from Universidade Estadual Paulista Júlio de Mesquita Filho (2001), a Master's Degree in statistics from the Federal University of São Carlos (2003), and a PhD from the Institute of Mathematics and Statistics of the University of São Paulo
- Ariane Ferreira Machado Avelar, RN, PhD, graduated from the Albert Einstein College of Nursing (1998), earned a Master's Degree in Federal Nursing from São Paulo (2003), and PhD in Sciences at the Federal University of São Paulo (2009). She is currently an associate professor at the Department of Pediatric Nursing (UNIFESP)
| | - Ariane Ferreira Machado Avelar
- Nursing School, Universidade Federal de São Paulo, São Paulo, Brazil (Drs Kita, Orsi, de Souza, and Avelar); Department of Biostatistics, Universidade Estadual Paulista Júlio de Mesquita Filho - Botucatu, São Paulo, Brazil (Dr Tsunemi)
- Vanessa Yukie Kita, RN, MNSc, earned a nursing degree from the Federal University of São Paulo - UNIFESP (2004) and a master of science degree (UNIFESP - 2019). She has experience in the field of nursing, with an emphasis on intensive care. She is currently professor of intensive care at UNIFESP Paulista School of Nursing
- Kelly Cristina Sbampato Calado Orsi, RN, PhD, earned a degree in nursing from the Federal University of São Paulo (2005), as well as a Master of Science (2015) and PhD in sciences at the Escola Paulista de Enfermagem (2019). She is currently professor at the Pediatric Nursing Department at Escola Paulista de Enfermagem/UNIFESP
- Adja Havreluk Paiva de Souza, RN, MNSc, earned a degree in nursing from the Federal University of São Paulo (2005), specialist in emergency nursing degree from the Federal University of São Paulo (2007), and Master of Science (UNIFESP - 2019)
- Miriam Harumi Tsunemi, PhD, earned a degree in statistics from Universidade Estadual Paulista Júlio de Mesquita Filho (2001), a Master's Degree in statistics from the Federal University of São Carlos (2003), and a PhD from the Institute of Mathematics and Statistics of the University of São Paulo
- Ariane Ferreira Machado Avelar, RN, PhD, graduated from the Albert Einstein College of Nursing (1998), earned a Master's Degree in Federal Nursing from São Paulo (2003), and PhD in Sciences at the Federal University of São Paulo (2009). She is currently an associate professor at the Department of Pediatric Nursing (UNIFESP)
| |
Collapse
|
7
|
Tzounakas VL, Anastasiadi AT, Karadimas DG, Velentzas AD, Anastasopoulou VI, Papageorgiou EG, Stamoulis K, Papassideri IS, Kriebardis AG, Antonelou MH. Early and Late-Phase 24 h Responses of Stored Red Blood Cells to Recipient-Mimicking Conditions. Front Physiol 2022; 13:907497. [PMID: 35721567 PMCID: PMC9198496 DOI: 10.3389/fphys.2022.907497] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
The 24-hour (24 h) post-transfusion survival of donor red blood cells (RBCs) is an important marker of transfusion efficacy. Nonetheless, within that period, donated RBCs may encounter challenges able to evoke rapid stress-responses. The aim of the present study was to assess the effect of exposure to plasma and body temperature upon stored RBCs under recipient-mimicking conditions in vitro from the first hours "post-transfusion" up to 24 h. For this purpose, packed RBCs from seven leukoreduced CPD/SAGM units were reconstituted with plasma of twenty-seven healthy individuals and incubated for 24 h at 37oC. Three units were additionally used to examine stress-responses in 3-hour intervals post mixing with plasma (n = 5) until 24 h. All experiments were performed in shortly-, medium-, and long-stored RBCs. Hemolysis, redox, morphology, membrane protein binding and vesiculation parameters were assessed. Even though spontaneous hemolysis was minimal post-reconstitution, it presented a time-dependent increase. A similar time-course profile was evident for the concentration of procoagulant extracellular vesicles and the osmotic fragility (shortly-stored RBCs). On the contrary, mechanical fragility and reactive oxygen species accumulation were characterized by increases in medium-stored RBCs, evident even from the first hours in the recipient-mimicking environment. Finally, exposure to plasma resulted in rapid improvement of morphology, especially in medium-stored RBCs. Overall, some RBC properties vary significantly during the first 24 h post-mixing, at levels different from both the storage ones and the standard end-of-24 h. Such findings may be useful for understanding the performance of RBCs and their possible clinical effects -especially on susceptible recipients- during the first hours post-transfusion.
Collapse
Affiliation(s)
- Vassilis L Tzounakas
- Department of Biology, School of Science, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Alkmini T Anastasiadi
- Department of Biology, School of Science, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Dimitrios G Karadimas
- Department of Biology, School of Science, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Athanassios D Velentzas
- Department of Biology, School of Science, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Violetta I Anastasopoulou
- Department of Biology, School of Science, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Effie G Papageorgiou
- Laboratory of Reliability and Quality Control in Laboratory Hematology (HemQcR), Department of Biomedical Sciences, School of Health and Welfare Sciences, University of West Attica (UniWA), Egaleo, Greece
| | | | - Issidora S Papassideri
- Department of Biology, School of Science, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Anastasios G Kriebardis
- Laboratory of Reliability and Quality Control in Laboratory Hematology (HemQcR), Department of Biomedical Sciences, School of Health and Welfare Sciences, University of West Attica (UniWA), Egaleo, Greece
| | - Marianna H Antonelou
- Department of Biology, School of Science, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| |
Collapse
|
8
|
Incidence of Medical Adhesive-Related Skin Injuries and Associated Factors After Pediatric Congenital Heart Surgery: A Prospective Cohort Study. J Wound Ostomy Continence Nurs 2022; 49:137-142. [PMID: 35255064 DOI: 10.1097/won.0000000000000855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to identify the incidence, characteristics, and factors associated with medical adhesive-related skin injuries (MARSI). DESIGN Prospective cohort study. SUBJECTS AND SETTINGS The sample comprised 136 children in the postoperative period after congenital heart surgery. The study setting was in a 31-bed pediatric surgical intensive care unit (ICU) of a university hospital in Sao Paulo, Brazil. METHODS Patients were followed from admission, with daily skin assessments, until the onset of MARSI or ICU discharge. Outcomes were compared by Fisher's exact test, Pearson's χ2 test, Mann-Whitney test, Brunner-Munzel test, and Welch 2-sample t test. RESULTS The incidence of MARSI was 60.3%, with 85 injuries in 82 patients. The highest occurrence was on postoperative day 2 (27 wounds; 31.8%). The most frequent medical adhesive associated with MARSI was transparent film dressing (n = 74; 86.6%). Factors associated with MARSI were age (P = .000), number of devices inserted (P = .000), Braden Q Scale score (P = .005), duration of surgery (P = .021), cardiopulmonary bypass duration (P = .000), duration of mechanical ventilation (P = .000), and length of ICU stay (P = .000). Children who developed MARSI received more blood components (P = .039), vasopressors (P = .000), and corticosteroids (P = 0.000); required longer sedation (P = .000); and had more edema (P = .001). CONCLUSION This high incidence indicates the need for greater awareness and prompt action in response to MARSI. Polyurethane transparent film without concurrent use of a skin barrier product should be avoided.
Collapse
|
9
|
Längst E, Tissot JD, Prudent M. Storage of red blood cell concentrates: Clinical impact. Transfus Clin Biol 2021; 28:397-402. [PMID: 34464712 DOI: 10.1016/j.tracli.2021.08.344] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 08/25/2021] [Indexed: 01/11/2023]
Abstract
The storage of red blood cells for transfusion purposes induces modifications of biochemical and biological properties. Moreover, these modifications are modulated by the donors' characteristics and the cell processing. These ex vivo alterations were suspected to decrease the transfusion efficiency and even to induce adverse events. This short article will review the red blood cells storage lesions and the clinical data related to them. In particular, the questions regarding the donors and recipients sex will be discussed.
Collapse
Affiliation(s)
- E Längst
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Épalinges, Switzerland; Faculté de Biologie et de Médecine, université de Lausanne, Lausanne, Switzerland
| | - J-D Tissot
- Faculté de Biologie et de Médecine, université de Lausanne, Lausanne, Switzerland
| | - M Prudent
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Épalinges, Switzerland; Faculté de Biologie et de Médecine, université de Lausanne, Lausanne, Switzerland; Center for Research and Innovation in Clinical Pharmaceutical Sciences, Institute of Pharmaceutical Sciences of Western Switzerland, University Hospital and University of Lausanne, Lausanne, Switzerland.
| |
Collapse
|
10
|
Processing methods and storage duration impact extracellular vesicle counts in red blood cell units. Blood Adv 2021; 4:5527-5539. [PMID: 33166402 DOI: 10.1182/bloodadvances.2020001658] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 08/24/2020] [Indexed: 12/14/2022] Open
Abstract
Extracellular vesicles (EVs) are active components of red blood cell (RBC) concentrates and may be associated with beneficial and adverse effects of transfusion. Elucidating controllable factors associated with EV release in RBC products is thus important to better manage the quality and properties of RBC units. Erythrocyte-derived EVs (EEVs) and platelet-derived EVs (PEVs) were counted in 1226 RBC units (administered to 280 patients) using a standardized cytometry-based method. EV size and CD47 and annexin V expression were also measured. The effects of donor characteristics, processing methods, and storage duration on EV counts were analyzed by using standard comparison tests, and analysis of covariance was used to determine factors independently associated with EV counts. PEV as well as EEV counts were higher in whole-blood-filtered RBC units compared with RBC-filtered units; PEV counts were associated with filter type (higher with filters associated with higher residual platelets), and CD47 expression was higher on EEVs in RBC units stored longer. Multivariate analysis showed that EEV counts were strongly associated with filter type (P < .0001), preparation, and storage time (+25.4 EEV/µL per day [P = .01] and +42.4 EEV/µL per day [P < .0001], respectively). The only independent factor associated with PEV counts was the residual platelet count in the unit (+67.1 PEV/µL; P < .0001). Overall, processing methods have an impact on EV counts and characteristics, leading to large variations in EV quantities transfused into patients. RBC unit processing methods might be standardized to control the EV content of RBC units if any impacts on patient outcomes can be confirmed. The IMIB (Impact of Microparticles in Blood) study is ancillary to the French ABLE (Age of Transfused Blood in Critically Ill Adults) trial (ISRCTN44878718).
Collapse
|
11
|
Rapid clearance of storage-induced microerythrocytes alters transfusion recovery. Blood 2021; 137:2285-2298. [PMID: 33657208 DOI: 10.1182/blood.2020008563] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 01/16/2021] [Indexed: 12/19/2022] Open
Abstract
Permanent availability of red blood cells (RBCs) for transfusion depends on refrigerated storage, during which morphologically altered RBCs accumulate. Among these, a subpopulation of small RBCs, comprising type III echinocytes, spheroechinocytes, and spherocytes and defined as storage-induced microerythrocytes (SMEs), could be rapidly cleared from circulation posttransfusion. We quantified the proportion of SMEs in RBC concentrates from healthy human volunteers and assessed correlation with transfusion recovery, investigated the fate of SMEs upon perfusion through human spleen ex vivo, and explored where and how SMEs are cleared in a mouse model of blood storage and transfusion. In healthy human volunteers, high proportion of SMEs in long-stored RBC concentrates correlated with poor transfusion recovery. When perfused through human spleen, 15% and 61% of long-stored RBCs and SMEs were cleared in 70 minutes, respectively. High initial proportion of SMEs also correlated with high retention of RBCs by perfused human spleen. In the mouse model, SMEs accumulated during storage. Transfusion of long-stored RBCs resulted in reduced posttransfusion recovery, mostly due to SME clearance. After transfusion in mice, long-stored RBCs accumulated predominantly in spleen and were ingested mainly by splenic and hepatic macrophages. In macrophage-depleted mice, splenic accumulation and SME clearance were delayed, and transfusion recovery was improved. In healthy hosts, SMEs were cleared predominantly by macrophages in spleen and liver. When this well-demarcated subpopulation of altered RBCs was abundant in RBC concentrates, transfusion recovery was diminished. SME quantification has the potential to improve blood product quality assessment. This trial was registered at www.clinicaltrials.gov as #NCT02889133.
Collapse
|
12
|
Bardyn M, Martin A, Dögnitz N, Abonnenc M, Dunham A, Yoshida T, Prudent M. Oxygen in Red Blood Cell Concentrates: Influence of Donors' Characteristics and Blood Processing. Front Physiol 2021; 11:616457. [PMID: 33424640 PMCID: PMC7786264 DOI: 10.3389/fphys.2020.616457] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 11/30/2020] [Indexed: 12/28/2022] Open
Abstract
Objective: Unexpectedly wide distribution (<10 to >90%) of hemoglobin oxygen saturation (sO2) within red cell concentrates (RCCs) has recently been observed. Causes of such variability are not yet completely explained whereas the roles of oxygen and oxidative lesions during the storage of RCCs are known. The objectives of the present study are to characterize sO2 distribution in RCCs produced in a Swiss blood center and to investigate the influence of processing and donors’ characteristics. Methods: The level of sO2 was measured in 1701 leukocyte-depleted RCCs derived from whole blood donations in both top–bottom (TB; component filtered, SAGM) and top–top (TT; whole blood filtration, PAGGSM) RCCs. The sO2 value was measured non-invasively through the PVC bag prior to storage by resonance Raman spectroscopy. Gender, age, blood type, hemoglobin level, and living altitude of donors, as well as process method and time-to-process were recorded. Results: Overall, the sO2 exhibited a wide non-Gaussian distribution with a mean of 51.2 ± 18.5%. Use of top-top kits resulted in a 16% higher sO2 (P < 0.0001) than with top-bottom ones. Waiting time before processing only had a modest impact, but the blood processing itself reduced the sO2 by almost 12% (P < 0.0001). sO2 was also significantly affected by some donors’ characteristics. RCCs from men exhibited 25% higher sO2 (P < 0.0001) than those donated by women. Multivariate analysis revealed that the apparent correlation observed with hemoglobin level and age was actually due to multicollinearity with the sex variable. Finally, we noticed no significant differences across blood type but found that altitude of residence was associated with the sO2 (i.e., higher in higher living place). Conclusion: These data confirm wide sO2 distribution in RCCs reported recently. The sO2 was impacted by the processing and also by donors’ characteristics such as the gender and the living altitude, but not by the hemoglobin level, blood group and donor age. This study provides new hints on the factors influencing red blood cells storage lesions, since they are known to be related to O2 content within the bags, giving clues to better process and to better store RCCs and therefore potentially improve the efficacy of transfusion.
Collapse
Affiliation(s)
- Manon Bardyn
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - Agathe Martin
- Laboratoire de Préparation Cellulaire et d'Analyses, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - Nora Dögnitz
- Département Approvisionnement Produits Sanguins, Transfusion Interrégionale CRS, Bern, Switzerland
| | - Mélanie Abonnenc
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland.,Laboratoire de Préparation Cellulaire et d'Analyses, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | | | | | - Michel Prudent
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland.,Centre de Transfusion Sanguine, Faculté de Biologie et de Médecine, Université de Lausanne, Lausanne, Switzerland
| |
Collapse
|
13
|
Marin M, Roussel C, Dussiot M, Ndour PA, Hermine O, Colin Y, Gray A, Landrigan M, Le Van Kim C, Buffet PA, Amireault P. Metabolic rejuvenation upgrades circulatory functions of red blood cells stored under blood bank conditions. Transfusion 2020; 61:903-918. [PMID: 33381865 DOI: 10.1111/trf.16245] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 11/13/2020] [Accepted: 11/15/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Red blood cells (RBC) change upon hypothermic conservation, and storage for 6 weeks is associated with the short-term clearance of 15% to 20% of transfused RBCs. Metabolic rejuvenation applied to RBCs before transfusion replenishes energetic sources and reverses most storage-related alterations, but how it impacts RBC circulatory functions has not been fully elucidated. STUDY DESIGN AND METHODS Six RBC units stored under blood bank conditions were analyzed weekly for 6 weeks and rejuvenated on Day 42 with an adenine-inosine-rich solution. Impact of storage and rejuvenation on adenosine triphosphate (ATP) levels, morphology, accumulation of storage-induced microerythrocytes (SMEs), elongation under an osmotic gradient (by LORRCA), hemolysis, and phosphatidylserine (PS) exposure was evaluated. The impact of rejuvenation on filterability and adhesive properties of stored RBCs was also assessed. RESULTS Rejuvenation of RBCs restored intracellular ATP to almost normal levels and decreased the PS exposure from 2.78% to 0.41%. Upon rejuvenation, the proportion of SME dropped from 28.2% to 9.5%, while the proportion of normal-shaped RBCs (discocytes and echinocytes 1) increased from 47.7% to 67.1%. In LORCCA experiments, rejuvenation did not modify the capacity of RBCs to elongate and induced a reduction in cell volume. In functional tests, rejuvenation increased RBC filterability in a biomimetic splenic filter (+16%) and prevented their adhesion to endothelial cells (-87%). CONCLUSION Rejuvenation reduces the proportion of morphologically altered and adhesive RBCs that accumulate during storage. Along with the improvement in their filterability, these data show that rejuvenation improves RBC properties related to their capacity to persist in circulation after transfusion.
Collapse
Affiliation(s)
- Mickaël Marin
- Université de Paris, UMR_S1134, BIGR, INSERM, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Laboratoire d'Excellence GR-Ex, Paris, France
| | - Camille Roussel
- Université de Paris, UMR_S1134, BIGR, INSERM, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Laboratoire d'Excellence GR-Ex, Paris, France.,Université de Paris, U1163, Laboratory of cellular and molecular mechanisms of hematological disorders and therapeutic implications, INSERM, Paris, France
| | - Michael Dussiot
- Laboratoire d'Excellence GR-Ex, Paris, France.,Université de Paris, U1163, Laboratory of cellular and molecular mechanisms of hematological disorders and therapeutic implications, INSERM, Paris, France
| | - Papa A Ndour
- Université de Paris, UMR_S1134, BIGR, INSERM, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Laboratoire d'Excellence GR-Ex, Paris, France
| | - Olivier Hermine
- Laboratoire d'Excellence GR-Ex, Paris, France.,Université de Paris, U1163, Laboratory of cellular and molecular mechanisms of hematological disorders and therapeutic implications, INSERM, Paris, France.,Assistance publique des hôpitaux de Paris, Paris, France
| | - Yves Colin
- Université de Paris, UMR_S1134, BIGR, INSERM, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Laboratoire d'Excellence GR-Ex, Paris, France
| | - Alan Gray
- Citra labs, a Zimmer Biomet company, Braintree, Massachusetts, USA
| | - Matt Landrigan
- Zimmer Biomet Southwest Ohio, Braintree, Massachusetts, USA
| | - Caroline Le Van Kim
- Université de Paris, UMR_S1134, BIGR, INSERM, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Laboratoire d'Excellence GR-Ex, Paris, France
| | - Pierre A Buffet
- Université de Paris, UMR_S1134, BIGR, INSERM, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Laboratoire d'Excellence GR-Ex, Paris, France.,Assistance publique des hôpitaux de Paris, Paris, France
| | - Pascal Amireault
- Université de Paris, UMR_S1134, BIGR, INSERM, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Laboratoire d'Excellence GR-Ex, Paris, France.,Université de Paris, U1163, Laboratory of cellular and molecular mechanisms of hematological disorders and therapeutic implications, INSERM, Paris, France
| |
Collapse
|
14
|
Two-step process of cytoskeletal structural damage during long-term storage of packed red blood cells. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2020; 19:124-134. [PMID: 33370227 DOI: 10.2450/2020.0220-20] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/25/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Storage of packed red blood cells (PRBC) for 42 days causes morphological, structural, and functional changes in the red cells. To assess the quality of stored PRBC, it is important to evaluate the main components of the product. The aim of this study was to evaluate the kinetics of the structural transformations in the cytoskeleton of red cells during long-term storage (up to 42 days). MATERIALS AND METHODS Bags of PRBC were stored with CPD/SAGM solution at +4 °C. Cytoskeletal parameters were measured on days 3, 12, 19, 21, 24, 28, 35, and 42 of storage to determine their changes. Atomic force microscopy was used to obtain images and analyse the parameters of the cytoskeletal network. As the storage time increased, a general PRBC test was performed. Membrane fixatives were not used at any stage of the preparation of the specimens for cytoskeletal imaging. RESULTS When PRBC were stored for 42 days, the main changes to the cytoskeletal mesh included rupture of filaments, merger of small pores into larger ones, a decrease of the number of pores, thickening of filaments, and an increase of membrane stiffness. A process of irreversible changes to the cytoskeleton started on days 19-21. A kinetic model of changes in the parameters of the cytoskeletal mesh with time of PRBC storage was created. DISCUSSION Two stages of impairment in cytoskeletal elements were found: rupture of filaments and clustering of protein components. The typical time of development and specifics of these stages are discussed. The consequences of the altered configuration of the cytoskeleton are also discussed. Destruction of the red cell cytoskeleton can have a negative effect on the efficacy of blood transfusion and increase the risk of post-transfusion complications. Our findings can be used in clinical medicine to evaluate the quality of PRBC for blood transfusion as well as for studies of the molecular organisation of red cells undergoing various types of physical and chemical treatment.
Collapse
|
15
|
Sherstyukova E, Chernysh A, Moroz V, Kozlova E, Sergunova V, Gudkova O. The relationship of membrane stiffness, cytoskeleton structure and storage time of pRBCs. Vox Sang 2020; 116:405-415. [PMID: 33103792 DOI: 10.1111/vox.13017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/10/2020] [Accepted: 09/22/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVES In clinical practice, it has been shown that transfusion of packed red blood cells (pRBCs) with late shelf life increases the risk of post-transfusion complications. OBJECTIVE To study relationship of membrane stiffness, cytoskeleton structure and storage time of pRBCs. MATERIALS AND METHODS pRBCs were processed and stored according to blood bank procedure, for 42 days, at +4°C; pRBC samples were taken on days 3, 12, 19, 21, 24, 28, 35 and 42. Cytoskeleton images and membrane stiffness were studied using atomic force microscope. RESULTS In the course of the pRBC storage, the cytoskeleton network configuration underwent structural changes. Simultaneously, pRBC membrane stiffness was increasing, with the correlation coefficient 0·88. Until 19 days, the stiffness grew slowly, in 19-24 days there occurred a transition period, after which its growth rate was three times higher than the initial. A chain of pathological processes developed in pRBC during long storage: pH reduction (linked to increased oxidative stress), then cytoskeletal destruction and an associated increase in pRBC membrane stiffness. CONCLUSION During prolonged storage of pRBCs and their acidification, there is a progression of pRBC cytoskeletal changes and associated increase of membrane stiffness, observed to increase in rate after days 19-24. Mutual measurements of cytoskeletal integrity and membrane stiffness may be useful quality assessment tool to study the molecular mechanisms of RBC structural degradation during storage.
Collapse
Affiliation(s)
- Ekaterina Sherstyukova
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, V.A. Negovsky Research Institute of General Reanimatology, Moscow, Russia.,Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Aleksandr Chernysh
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, V.A. Negovsky Research Institute of General Reanimatology, Moscow, Russia.,Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Viktor Moroz
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, V.A. Negovsky Research Institute of General Reanimatology, Moscow, Russia
| | - Elena Kozlova
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, V.A. Negovsky Research Institute of General Reanimatology, Moscow, Russia.,Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Viktoria Sergunova
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, V.A. Negovsky Research Institute of General Reanimatology, Moscow, Russia
| | - Olga Gudkova
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, V.A. Negovsky Research Institute of General Reanimatology, Moscow, Russia
| |
Collapse
|
16
|
Abstract
The in vitro production of red blood cells and platelets is a groundbreaking technology that can-when optimized-surrogate for donated blood cells, in total or in part. Here we discuss questions that may arise when the technology is available, relative to safety issues (comprising both quantitative and qualitative parameters) and to ethics, an item often forgotten in the debates so far.
Collapse
Affiliation(s)
- Olivier Garraud
- Faculty of Medicine, University of Lyon, 42023, Saint-Etienne, France; Institut National de la Transfusion Sanguine, 75015, Paris, France; Palliative Care Unit, The Ruffec Hospital, 16700, Ruffec, France.
| |
Collapse
|
17
|
Burgara-Estrella AJ, Acosta-Elías MA, Álvarez-Bajo O, Silva-Campa E, Angulo-Molina A, Rodríguez-Hernández IDC, Sarabia-Sainz HM, Escalante-Lugo VM, Pedroza-Montero MR. Atomic force microscopy and Raman spectra profile of blood components associated with exposure to cigarette smoking. RSC Adv 2020; 10:11971-11981. [PMID: 35496627 PMCID: PMC9050830 DOI: 10.1039/d0ra01384f] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 03/06/2020] [Indexed: 11/21/2022] Open
Abstract
Tobacco smoke contains several compounds with oxidant and pro-oxidant properties with the capability of producing structural changes in biomolecules, as well as cell damage. This work aimed to describe and analyse the effect of tobacco smoke on human blood components, red blood cell (RBC) membrane, haemoglobin (Hb) and blood plasma by Atomic Force Microscopy (AFM) and Raman spectroscopy. Our results indicate that tobacco induced RBC membrane nano-alterations characterized by diminished RBC diameter and increased nano-vesicles formation, and RBC fragility. The Raman spectra profile suggests modifications in chemical composition specifically found in peaks 1135 cm-1, 1156 cm-1, 1452 cm-1 and intensity relation of peaks 1195 cm-1 and 1210 cm-1 of blood plasma and by change of peaks 1338 cm-1, 1357 cm-1, 1549 cm-1 and 1605 cm-1 associated with the pyrrole ring of Hb. The relevance of these results lies in the identification of a profile of structural and chemical alterations that serves as a biomarker of physiological and pathological conditions in the human blood components induced by tobacco exposure using AFM and the Raman spectroscopy as tools for monitoring them.
Collapse
Affiliation(s)
| | | | - Osiris Álvarez-Bajo
- CONACYT-Departamento de Investigación en Física, Universidad de Sonora Hermosillo Mexico
| | - Erika Silva-Campa
- Departamento de Investigación en Física, Universidad de Sonora Hermosillo Mexico
| | - Aracely Angulo-Molina
- Departamento de Investigación en Física, Universidad de Sonora Hermosillo Mexico
- Departamento de Ciencias Químico Biológicas, Universidad de Sonora Hermosillo Mexico
| | | | - Héctor M Sarabia-Sainz
- Departamento de Ciencias del Deporte y de la Actividad Física, Universidad de Sonora Hermosillo Mexico
| | | | | |
Collapse
|
18
|
Cigarette smoking and antioxidant defences in packed red blood cells prior to storage. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2019; 18:40-48. [PMID: 31855151 DOI: 10.2450/2019.0166-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 10/14/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Red blood cells from smoking donors can have more lesions from oxidative stress, decreasing the benefits of blood transfusion. We aimed to explore the effect of cigarette smoking on the oxidative status of packed red blood cells (PRBCs) prior to storage. MATERIALS AND METHODS We compared serum vitamin C, plasmatic malondialdehyde (MDA), and non-protein thiol groups (GSH) levels in PRBCs, as well glutathione peroxidase (GPx) and glutathione s-transferase (GST) activity in PRBCs from smoking (n=36) and non-smoking (n=36) donors. We also correlated urinary cotinine levels with these parameters. RESULTS Cigarette smoking was associated with decreased serum levels of vitamin C and GPx, and increased GST activity in PRBCs. We found negative correlations between cotinine, GPx activity and vitamin C levels, and a positive correlation between cotinine and GST activity. DISCUSSION Cigarette smoking changed antioxidant defences of PRBCs prior to storage and these parameters are correlated with cotinine levels. Increased RBC antioxidants such as GST may reflect an exposure to oxidants during erythropoiesis. Because of the inability of mature RBCs to resynthesise antioxidants, PRBCs from smokers may have higher risk of storage lesions than those from non-smoker donors.
Collapse
|
19
|
Koch CG, Sessler DI, Duncan AE, Mascha EJ, Li L, Yang D, Figueroa P, Sabik JF, Mihaljevic T, Svensson LG, Blackstone EH. Effect of red blood cell storage duration on major postoperative complications in cardiac surgery: A randomized trial. J Thorac Cardiovasc Surg 2019; 160:1505-1514.e3. [PMID: 31813538 DOI: 10.1016/j.jtcvs.2019.09.165] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 09/18/2019] [Accepted: 09/29/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Although observational studies suggest an association between transfusion of older red blood cell (RBC) units and increased postoperative risk, randomized trials have not supported this. The objective of this randomized trial was to test the effect of RBC storage age on outcomes after cardiac surgery. METHODS From July 2007 to May 2016, 3835 adults undergoing coronary artery bypass grafting, cardiac valve procedures, or ascending aorta repair, either alone or in combination, were randomized to transfusion of RBCs stored for ≤14 days (younger units) or for ≥20 days (older units) intraoperatively and throughout the postoperative hospitalization. According to protocol, 2448 patients were excluded because they did not receive RBC transfusions. Among the remaining 1387 modified intent-to-treat patients, 701 were randomized to receive younger RBC units (median age, 11 days) and the remaining 686 to receive older units (median age, 25 days). The primary endpoint was composite morbidity and mortality, analyzed using a generalized estimating equation (GEE) model. The trial was discontinued midway owing to enrollment constraints. RESULTS A total of 5470 RBC units were transfused, including 2783 in the younger RBC storage group and 2687 in the older RBC storage group. The GEE average relative-effect odds ratio was 0.77 (95% confidence interval [CI], 0.50-1.19; P = .083) for the composite morbidity and mortality endpoint. In-hospital mortality was lower for the younger RBC storage group (2.1% [n = 15] vs 3.4% [n = 23]), as was occurrence of other adverse events except for atrial fibrillation, although all CIs crossed 1.0. CONCLUSIONS This clinical trial, which was stopped at its midpoint owing to enrollment constraints, supports neither the efficacy nor the futility of transfusing either younger or older RBC units. The effects of transfusing RBCs after even more prolonged storage (35-42 days) remains untested.
Collapse
Affiliation(s)
- Colleen G Koch
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medicine, Baltimore, Md.
| | - Daniel I Sessler
- Department of Outcomes Researc, Cleveland Clinic, Cleveland, Ohio
| | - Andra E Duncan
- Department of Cardiothoracic Anesthesiology, Cleveland Clinic, Cleveland, Ohio
| | - Edward J Mascha
- Department of Outcomes Researc, Cleveland Clinic, Cleveland, Ohio; Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
| | - Liang Li
- Division of Science, Department of Biostatistics, MD Anderson Cancer Center, Houston, Tex
| | - Dongsheng Yang
- Department of Outcomes Researc, Cleveland Clinic, Cleveland, Ohio; Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
| | | | - Joseph F Sabik
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Tomislav Mihaljevic
- Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Lars G Svensson
- Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Eugene H Blackstone
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio; Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio
| |
Collapse
|
20
|
Obonyo NG, Byrne L, Tung JP, Simonova G, Diab SD, Dunster KR, Passmore MR, Boon AC, See Hoe L, Engkilde-Pedersen S, Esguerra-Lallen A, Fauzi MH, Pimenta LP, Millar JE, Fanning JP, Van Haren F, Anstey CM, Cullen L, Suen J, Shekar K, Maitland K, Fraser JF. Pre-clinical study protocol: Blood transfusion in endotoxaemic shock. MethodsX 2019; 6:1124-1132. [PMID: 31193460 PMCID: PMC6529713 DOI: 10.1016/j.mex.2019.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 05/04/2019] [Indexed: 12/29/2022] Open
Abstract
The Surviving Sepsis Campaign (SCC) and the American College of Critical Care Medicine (ACCM) guidelines recommend blood transfusion in sepsis when the haemoglobin concentration drops below 7.0 g/dL and 10.0 g/dL respectively, while the World Health Organisation (WHO) guideline recommends transfusion in septic shock 'if intravenous (IV) fluids do not maintain adequate circulation', as a supportive measure of last resort. Volume expansion using crystalloid and colloid fluid boluses for haemodynamic resuscitation in severe illness/sepsis, has been associated with adverse outcomes in recent literature. However, the volume expansion effect(s) following blood transfusion for haemodynamic circulatory support, in severe illness remain unclear with most previous studies having focused on evaluating effects of either different RBC storage durations (short versus long duration) or haemoglobin thresholds (low versus high threshold) pre-transfusion. •We describe the protocol for a pre-clinical randomised controlled trial designed to examine haemodynamic effect(s) of early volume expansion using packed RBCs (PRBCs) transfusion (before any crystalloids or colloids) in a validated ovine-model of hyperdynamic endotoxaemic shock.•Additional exploration of mechanisms underlying any physiological, haemodynamic, haematological, immunologic and tissue specific-effects of blood transfusion will be undertaken including comparison of effects of short (≤5 days) versus long (≥30 days) storage duration of PRBCs prior to transfusion.
Collapse
Affiliation(s)
- Nchafatso G. Obonyo
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- IDeAL/KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Liam Byrne
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- The Canberra Hospital Intensive Care, Garran, ACT, Australia
- Australia National University, Canberra, ACT, Australia
| | - John-Paul Tung
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Australian Red Cross Blood Service, Kelvin Grove, Brisbane, Queensland, Australia
- University of Queensland, Brisbane, QLD, Australia
- Queensland University of Technology, Brisbane City, QLD Australia
| | - Gabriela Simonova
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Australian Red Cross Blood Service, Kelvin Grove, Brisbane, Queensland, Australia
- University of Queensland, Brisbane, QLD, Australia
| | - Sara D. Diab
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- University of Queensland, Brisbane, QLD, Australia
| | - Kimble R. Dunster
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Queensland University of Technology, Brisbane City, QLD Australia
| | - Margaret R. Passmore
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- University of Queensland, Brisbane, QLD, Australia
| | - Ai-Ching Boon
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- University of Queensland, Brisbane, QLD, Australia
| | - Louise See Hoe
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- University of Queensland, Brisbane, QLD, Australia
| | - Sanne Engkilde-Pedersen
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Australian Red Cross Blood Service, Kelvin Grove, Brisbane, Queensland, Australia
- Queensland University of Technology, Brisbane City, QLD Australia
| | - Arlanna Esguerra-Lallen
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Australian Red Cross Blood Service, Kelvin Grove, Brisbane, Queensland, Australia
| | - Mohd H. Fauzi
- School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kelantan, Malaysia
| | - Leticia P. Pimenta
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
| | - Jonathan E. Millar
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- University of Queensland, Brisbane, QLD, Australia
| | - Jonathon P. Fanning
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- University of Queensland, Brisbane, QLD, Australia
| | - Frank Van Haren
- The Canberra Hospital Intensive Care, Garran, ACT, Australia
- Australia National University, Canberra, ACT, Australia
- The University of Canberra, Bruce, ACT, Australia
| | - Chris M. Anstey
- Sunshine Coast University Hospital Intensive Care, Birtinya, Qld, Australia
| | - Louise Cullen
- University of Queensland, Brisbane, QLD, Australia
- Royal Brisbane and Women’s Hospital, Herston, QLD, Australia
| | - Jacky Suen
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- University of Queensland, Brisbane, QLD, Australia
| | - Kiran Shekar
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- University of Queensland, Brisbane, QLD, Australia
- Adult Intensive Care, The Prince Charles Hospital, Chermside, Brisbane, QLD, Australia
| | - Kathryn Maitland
- IDeAL/KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Paediatrics, Faculty of Medicine, Imperial College London, United Kingdom
| | - John F. Fraser
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- University of Queensland, Brisbane, QLD, Australia
- Queensland University of Technology, Brisbane City, QLD Australia
- Adult Intensive Care, The Prince Charles Hospital, Chermside, Brisbane, QLD, Australia
| |
Collapse
|
21
|
Abonnenc M, Tissot JD, Prudent M. General overview of blood products in vitro quality: Processing and storage lesions. Transfus Clin Biol 2018; 25:269-275. [PMID: 30241785 DOI: 10.1016/j.tracli.2018.08.162] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 08/29/2018] [Indexed: 12/12/2022]
Abstract
Blood products are issued from blood collection. Collected blood is immediately mixed with anticoagulant solutions that immediately induce chemical and/or biochemical modifications. Collected blood is then transformed into different blood products according to various steps of fabrication. All these steps induce either reversible or irreversible "preparation-related" lesions that combine with "storage-related" lesions. This short paper aims to provide an overview of the alterations that are induced by the "non-physiological" processes used to prepare blood products that are used in clinical practice.
Collapse
Affiliation(s)
- Mélanie Abonnenc
- Transfusion interrégionale CRS, laboratoire de recherche sur les produits sanguins, route de la Corniche 2, 1066 Epalinges, Switzerland
| | - Jean-Daniel Tissot
- Transfusion interrégionale CRS, laboratoire de recherche sur les produits sanguins, route de la Corniche 2, 1066 Epalinges, Switzerland; Faculté de biologie et de médecine, université de Lausanne, Lausanne, Switzerland
| | - Michel Prudent
- Transfusion interrégionale CRS, laboratoire de recherche sur les produits sanguins, route de la Corniche 2, 1066 Epalinges, Switzerland; Faculté de biologie et de médecine, université de Lausanne, Lausanne, Switzerland.
| |
Collapse
|
22
|
Koch CG, Duncan AI, Figueroa P, Dai L, Sessler DI, Frank SM, Ness PM, Mihaljevic T, Blackstone EH. Real Age: Red Blood Cell Aging During Storage. Ann Thorac Surg 2018; 107:973-980. [PMID: 30342044 DOI: 10.1016/j.athoracsur.2018.08.073] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 07/10/2018] [Accepted: 08/20/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND During cold storage, some red blood cell (RBC) units age more rapidly than others. Yet, the Food and Drug Administration has set a uniform storage limit of 42 days. Objectives of this review are to present evidence for an RBC storage lesion and suggest that functional measures of stored RBC quality-which we call real age-may be more appropriate than calendar age. METHODS During RBC storage, biochemical substances and byproducts accumulate and RBC shape alters. Factors that influence the rate of degradation include donor characteristics, bio-preservation conditions, and vesiculation. Better understanding of markers of RBC quality may lead to standardized, quantifiable, and operationally practical measures to improve donor selection, assess quality of an RBC unit, improve storage conditions, and test efficacy of the transfused product. RESULTS The conundrum is that clinical trials of younger versus older RBC units have not aligned with in vitro aging data; that is, the units transfused were not old enough. In vitro changes are considerable beyond 28 to 35 days, and average storage age for older transfused units was 14 to 21 days. CONCLUSIONS RBC product real age varies by donor characteristics, storage conditions, and biological changes during storage. Metrics to measure temporal changes in quality of the stored RBC product may be more appropriate than the 42-day expiration date. Randomized trials and observational studies are focused on average effect, but, in the evolving age of precision medicine, we must acknowledge that vulnerable populations and individuals may be harmed by aging blood.
Collapse
Affiliation(s)
- Colleen G Koch
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medicine, Baltimore, Maryland.
| | - Andra I Duncan
- Department of Cardiothoracic Anesthesiology, Cleveland Clinic, Cleveland, Ohio
| | | | - Lu Dai
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, Ohio
| | - Daniel I Sessler
- Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio
| | - Steven M Frank
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medicine, Baltimore, Maryland
| | - Paul M Ness
- Department of Transfusion Medicine, Johns Hopkins Medicine, Baltimore, Maryland
| | - Tomislav Mihaljevic
- Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Eugene H Blackstone
- Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio; Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
| |
Collapse
|
23
|
Barshtein G, Arbell D, Livshits L, Gural A. Is It Possible to Reverse the Storage-Induced Lesion of Red Blood Cells? Front Physiol 2018; 9:914. [PMID: 30087617 PMCID: PMC6066962 DOI: 10.3389/fphys.2018.00914] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 06/22/2018] [Indexed: 12/12/2022] Open
Abstract
Cold-storage of packed red blood cells (PRBCs) in the blood bank is reportedly associated with alteration in a wide range of RBC features, which change cell storage each on its own timescale. Thus, some of the changes take place at an early stage of storage (during the first 7 days), while others occur later. We still do not have a clear understanding what happens to the damaged PRBC following their transfusion. We know that some portion (from a few to 10%) of transfused cells with a high degree of damage are removed from the bloodstream immediately or in the first hour(s) after the transfusion. The remaining cells partially restore their functionality and remain in the recipient’s blood for a longer time. Thus, the ability of transfused cells to recover is a significant factor in PRBC transfusion effectiveness. In the present review, we discuss publications that examined RBC lesions induced by the cold storage, aiming to offer a better understanding of the time frame in which these lesions occur, with particular emphasis on the question of their reversibility. We argue that transfused RBCs are capable (in a matter of a few hours) of restoring their pre-storage levels of ATP and 2,3-DPG, with subsequent restoration of cell functionality, especially of those properties having a more pronounced ATP-dependence. The extent of reversal is inversely proportional to the extent of damage, and some of the changes cannot be reversed.
Collapse
Affiliation(s)
- Gregory Barshtein
- Faculty of Medicine, Biochemistry Department, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Dan Arbell
- Pediatric Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Leonid Livshits
- Faculty of Medicine, Biochemistry Department, Hebrew University of Jerusalem, Jerusalem, Israel.,Institute of Veterinary Physiology, University of Zurich, Zürich, Switzerland
| | - Alexander Gural
- Blood Bank, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| |
Collapse
|
24
|
The 3-phase evolution of stored red blood cells and the clinical trials: an obvious relationship. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2018; 15:188. [PMID: 28263178 DOI: 10.2450/2017.0317-16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 12/05/2016] [Indexed: 12/26/2022]
|
25
|
Ng MSY, David M, Middelburg RA, Ng ASY, Suen JY, Tung JP, Fraser JF. Transfusion of packed red blood cells at the end of shelf life is associated with increased risk of mortality - a pooled patient data analysis of 16 observational trials. Haematologica 2018; 103:1542-1548. [PMID: 29794148 PMCID: PMC6119129 DOI: 10.3324/haematol.2018.191932] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 02/22/2018] [Indexed: 12/13/2022] Open
Abstract
Observational studies address packed red blood cell effects at the end of shelf life and have larger sample sizes compared to randomized control trials. Meta-analyses combining data from observational studies have been complicated by differences in aggregate transfused packed red blood cell age and outcome reporting. This study abrogated these issues by taking a pooled patient data approach. Observational studies reporting packed red blood cell age and clinical outcomes were identified and patient-level data sets were sought from investigators. Odds ratios and 95% confidence intervals for binary outcomes were calculated for each study, with mean packed red blood cell age or maximum packed red blood cell age acting as independent variables. The relationship between mean packed red blood cell age and hospital length of stay for each paper was analyzed using zero-inflated Poisson regression. Random effects models combined paper-level effect estimates. Extremes analyses were completed by comparing patients transfused with mean packed red blood cell aged less than ten days to those transfused with mean packed red blood cell aged at least 30 days. sixteen datasets were available for pooled patient data analysis. Mean packed red blood cell age of at least 30 days was associated with an increased risk of in-hospital mortality compared to mean packed red blood cell of less than ten days (odds ratio: 3.25, 95% confidence interval: 1.27–8.29). Packed red blood cell age was not correlated to increased risks of nosocomial infection or prolonged length of hospital stay.
Collapse
Affiliation(s)
- Monica S Y Ng
- Critical Care Research Group, Faculty of Medicine, University of Queensland, Brisbane, Australia .,Research and Development, Australian Red Cross Blood Service, Brisbane, Australia
| | - Michael David
- School of Medicine and Population Health, The University of Newcastle, Callaghan, Australia
| | - Rutger A Middelburg
- Centre for Clinical Transfusion Research, Sanquin Research, Leiden, the Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Center, the Netherlands
| | - Angela S Y Ng
- Critical Care Research Group, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Jacky Y Suen
- Critical Care Research Group, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - John-Paul Tung
- Critical Care Research Group, Faculty of Medicine, University of Queensland, Brisbane, Australia.,Research and Development, Australian Red Cross Blood Service, Brisbane, Australia
| | - John F Fraser
- Critical Care Research Group, Faculty of Medicine, University of Queensland, Brisbane, Australia
| |
Collapse
|
26
|
Roussel C, Buffet PA, Amireault P. Measuring Post-transfusion Recovery and Survival of Red Blood Cells: Strengths and Weaknesses of Chromium-51 Labeling and Alternative Methods. Front Med (Lausanne) 2018; 5:130. [PMID: 29868587 PMCID: PMC5962717 DOI: 10.3389/fmed.2018.00130] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/19/2018] [Indexed: 12/17/2022] Open
Abstract
The proportion of transfused red blood cells (RBCs) that remain in circulation is an important surrogate marker of transfusion efficacy and contributes to predict the potential benefit of a transfusion process. Over the last 50 years, most of the transfusion recovery data were generated by chromium-51 (51Cr)-labeling studies and were predominantly performed to validate new storage systems and new processes to prepare RBC concentrates. As a consequence, our understanding of transfusion efficacy is strongly dependent on the strengths and weaknesses of 51Cr labeling in particular. Other methods such as antigen mismatch or biotin-based labeling can bring relevant information, for example, on the long-term survival of transfused RBC. These radioactivity-free methods can be used in patients including from vulnerable groups. We provide an overview of the methods used to measure transfusion recovery in humans, compare their strengths and weaknesses, and discuss their potential limitations. Also, based on our understanding of the spleen-specific filtration of damaged RBC and historical transfusion recovery data, we propose that RBC deformability and morphology are storage lesion markers that could become useful predictors of transfusion recovery. Transfusion recovery can and should be accurately explored by more than one method. Technical optimization and clarification of concepts is still needed in this important field of transfusion and physiology.
Collapse
Affiliation(s)
- Camille Roussel
- Biologie Intégrée du Globule Rouge UMR_S1134, INSERM, Univ. Paris Diderot, Sorbonne Paris Cité, Univ. de la Réunion, Univ. des Antilles, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Laboratoire d'Excellence GR-Ex, Paris, France.,Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutic Implications U1163/CNRS ERL 8254, INSERM, CNRS, Univ Paris Descartes, Sorbonne Paris Cité, Paris, France.,Université Paris Descartes, Paris, France
| | - Pierre A Buffet
- Biologie Intégrée du Globule Rouge UMR_S1134, INSERM, Univ. Paris Diderot, Sorbonne Paris Cité, Univ. de la Réunion, Univ. des Antilles, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Laboratoire d'Excellence GR-Ex, Paris, France.,Université Paris Descartes, Paris, France.,Assistance publique des hôpitaux de Paris, Paris, France
| | - Pascal Amireault
- Biologie Intégrée du Globule Rouge UMR_S1134, INSERM, Univ. Paris Diderot, Sorbonne Paris Cité, Univ. de la Réunion, Univ. des Antilles, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Laboratoire d'Excellence GR-Ex, Paris, France.,Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutic Implications U1163/CNRS ERL 8254, INSERM, CNRS, Univ Paris Descartes, Sorbonne Paris Cité, Paris, France
| |
Collapse
|
27
|
Prudent M, Delobel J, Hübner A, Benay C, Lion N, Tissot JD. Proteomics of Stored Red Blood Cell Membrane and Storage-Induced Microvesicles Reveals the Association of Flotillin-2 With Band 3 Complexes. Front Physiol 2018; 9:421. [PMID: 29780325 PMCID: PMC5945891 DOI: 10.3389/fphys.2018.00421] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 04/04/2018] [Indexed: 12/15/2022] Open
Abstract
The storage of erythrocyte concentrates (ECs) induces lesions that notably affect metabolism, protein activity, deformability of red blood cells (RBCs), as well as the release of oxygen. Band 3 is one of the proteins affected during the ex vivo aging of RBCs. This membrane protein is an anion transporter, an anchor site for the cytoskeleton and other membrane proteins as well as a binding site for glycolytic enzymes and bears blood group antigens. In the present study, band 3 complexes were isolated from RBCs stored for 7 and 42 days in average (n = 3), as well as from microvesicles (n = 3). After extraction of membrane proteins with a deoxycholate containing buffer, band 3 complexes were co-immunoprecipitated on magnetic beads coated with two anti-band 3 antibodies. Both total membrane protein extracts and eluates (containing band 3 complexes) were separated on SDS-PAGE and analyzed by bottom-up proteomics. It revealed that three proteins were present or absent in band 3 complexes stemming from long-stored or short-stored ECs, respectively, whereas the membrane protein contents remained equivalent. These potential markers for storage-induced RBC aging are adenylosuccinate lyase (ADSL), α-adducin and flotillin-2, and were further analyzed using western blots. ADSL abundance tended to increase during storage in both total membrane protein and band 3 complexes, whereas α-adducin mainly tended to stay onto the membrane extract. Interestingly, flotillin-2 was equivalently present in total membrane proteins whereas it clearly co-immunoprecipitated with band 3 complexes during storage (1.6-fold-change, p = 0.0024). Moreover, flotillin-2 was enriched (almost threefold) in RBCs compared to microvesicles (MVs) (p < 0.001) and the amount found in MVs was associated to band 3 complexes. Different types of band 3 complexes are known to exist in RBCs and further studies will be required to better understand involvement of this protein in microvesiculation during the storage of RBCs.
Collapse
Affiliation(s)
- Michel Prudent
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement Produits, Transfusion Interrégionale CRS, Épalinges, Switzerland.,Faculté de Biologie et de Médecine, Université de Lausanne, Lausanne, Switzerland
| | - Julien Delobel
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement Produits, Transfusion Interrégionale CRS, Épalinges, Switzerland
| | - Aurélie Hübner
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement Produits, Transfusion Interrégionale CRS, Épalinges, Switzerland
| | - Corinne Benay
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement Produits, Transfusion Interrégionale CRS, Épalinges, Switzerland
| | - Niels Lion
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement Produits, Transfusion Interrégionale CRS, Épalinges, Switzerland.,Faculté de Biologie et de Médecine, Université de Lausanne, Lausanne, Switzerland
| | - Jean-Daniel Tissot
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement Produits, Transfusion Interrégionale CRS, Épalinges, Switzerland.,Faculté de Biologie et de Médecine, Université de Lausanne, Lausanne, Switzerland
| |
Collapse
|
28
|
Red blood cells ageing markers: a multi-parametric analysis. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2018; 15:239-248. [PMID: 28518051 DOI: 10.2450/2017.0318-16] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 12/05/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND Red blood cells collected in citrate-phosphate-dextrose can be stored for up to 42 days at 4 °C in saline-adenine-glucose-mannitol additive solution. During this controlled, but nevertheless artificial, ex vivo ageing, red blood cells accumulate lesions that can be reversible or irreversible upon transfusion. The aim of the present study is to follow several parameters reflecting cell metabolism, antioxidant defences, morphology and membrane dynamics during storage. MATERIALS AND METHODS Five erythrocyte concentrates were followed weekly during 71 days. Extracellular glucose and lactate concentrations, total antioxidant power, as well as reduced and oxidised intracellular glutathione levels were quantified. Microvesiculation, percentage of haemolysis and haematologic parameters were also evaluated. Finally, morphological changes and membrane fluctuations were recorded using label-free digital holographic microscopy. RESULTS The antioxidant power as well as the intracellular glutathione concentration first increased, reaching maximal values after one and two weeks, respectively. Irreversible morphological lesions appeared during week 5, where discocytes began to transform into transient echinocytes and finally spherocytes. At the same time, the microvesiculation and haemolysis started to rise exponentially. After six weeks (expiration date), intracellular glutathione was reduced by 25%, reflecting increasing oxidative stress. The membrane fluctuations showed decreased amplitudes during shape transition from discocytes to spherocytes. DISCUSSION Various types of lesions accumulated at different chemical and cellular levels during storage, which could impact their in vivo recovery after transfusion. A marked effect was observed after four weeks of storage, which corroborates recent clinical data. The prolonged follow-up period allowed the capture of deep storage lesions. Interestingly, and as previously described, the severity of the changes differed among donors.
Collapse
|
29
|
Delobel J, Prudent M, Crettaz D, ElHajj Z, Riederer BM, Tissot JD, Lion N. Cysteine redox proteomics of the hemoglobin-depleted cytosolic fraction of stored red blood cells. Proteomics Clin Appl 2017; 10:883-93. [PMID: 27377365 DOI: 10.1002/prca.201500132] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 05/02/2016] [Accepted: 06/30/2016] [Indexed: 01/17/2023]
Abstract
PURPOSE Erythrocyte concentrates (ECs) represent the most transfused labile blood products. They are stored at 4°C in additive solutions for up to 56 days. Protein oxidation is a marker of oxidative stress and cysteine residues, whose oxidations are required for physiological cell functions, are highly prone to such modification. EXPERIMENTAL DESIGN Five ECs from independent donations were followed. Soluble protein extracts were prepared at days 6, 27, and 41, and cysteines were alkylated, reduced, and labeled with infrared dyes. Samples were mixed two by two (day 6 as reference) and analyzed by 2D-DIGE. Detection of labeled cysteines allows quantitative comparison of oxidative status. Spots of interest were analyzed by proteomics. RESULTS Thirty-two spots containing 43 proteins were classified as increasing, decreasing, or exhibiting a peak of expression during storage. Proteins having catalytic and antioxidant activities were particularly affected during storage, for example, peroxiredoxin-1 and DJ-1 were reversibly oxidized and catalase was irreversibly oxidized. These proteins could be used to evaluate different storage strategies to maintain proper protein function during the overall storage period. CONCLUSIONS AND CLINICAL RELEVANCE This redox-DIGE approach brings new quantitative data on oxidized proteins in stored red blood cells. As previously reported on carbonylation, the oxidative damages differently affect protein functions.
Collapse
Affiliation(s)
- Julien Delobel
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - Michel Prudent
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - David Crettaz
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - Zeinab ElHajj
- Centre des Neurosciences Psychiatriques, Hôpital de Cery-CHUV, Prilly, Switzerland
| | - Beat M Riederer
- Centre des Neurosciences Psychiatriques, Hôpital de Cery-CHUV, Prilly, Switzerland
| | - Jean-Daniel Tissot
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - Niels Lion
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| |
Collapse
|
30
|
Bardyn M, Tissot JD, Prudent M. Oxidative stress and antioxidant defenses during blood processing and storage of erythrocyte concentrates. Transfus Clin Biol 2017; 25:96-100. [PMID: 28888839 DOI: 10.1016/j.tracli.2017.08.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 08/02/2017] [Indexed: 10/18/2022]
Abstract
Oxidative lesions start accumulating in cells when the oxidant attacks overwhelm the antioxidant defenses. This review will briefly describe red blood cell storage lesions with emphasis on the consequences of oxidation and the cellular defense mechanisms, as well as the methods that can be used to monitor them. The sources of variability in red blood cell storage capacity depend on the donor characteristics, the product processing and the storage conditions. Suggestions to improve the product quality in order to ensure the best efficacy and safety for the transfused patient are also discussed.
Collapse
Affiliation(s)
- M Bardyn
- Transfusion interrégionale CRS, laboratoire de recherche sur les produits sanguins, 2, route de la Corniche, 1066 Epalinges, Switzerland
| | - J-D Tissot
- Transfusion interrégionale CRS, laboratoire de recherche sur les produits sanguins, 2, route de la Corniche, 1066 Epalinges, Switzerland; Faculté de biologie et de médecine, Université de Lausanne, Lausanne, Switzerland
| | - M Prudent
- Transfusion interrégionale CRS, laboratoire de recherche sur les produits sanguins, 2, route de la Corniche, 1066 Epalinges, Switzerland; Faculté de biologie et de médecine, Université de Lausanne, Lausanne, Switzerland.
| |
Collapse
|
31
|
The storage lesions: From past to future. Transfus Clin Biol 2017; 24:277-284. [DOI: 10.1016/j.tracli.2017.05.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 05/30/2017] [Indexed: 12/18/2022]
|
32
|
Bardyn M, Maye S, Lesch A, Delobel J, Tissot JD, Cortés-Salazar F, Tacchini P, Lion N, Girault HH, Prudent M. The antioxidant capacity of erythrocyte concentrates is increased during the first week of storage and correlated with the uric acid level. Vox Sang 2017; 112:638-647. [PMID: 28833258 DOI: 10.1111/vox.12563] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 07/04/2017] [Accepted: 07/09/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Red blood cells (RBCs) suffer from lesions during cold storage, depending in part on their ability to counterbalance oxidative stress by activating their antioxidant defence. The aim of this study was to monitor the antioxidant power (AOP) in erythrocyte concentrates (ECs) during cold storage. MATERIALS AND METHODS Six ECs were prepared in saline-adenine-glucose-mannitol (SAGM) additive solution and followed during 43 days. The AOP was quantified electrochemically using disposable electrode strips and compared with results obtained from a colorimetric assay. Haematological data, data on haemolysis and the extracellular concentration of uric acid were also recorded. Additionally, a kinetic model was developed to extract quantitative kinetic data on the AOP behaviour. RESULTS The AOP of total ECs and their extracellular samples attained a maximum after 1 week of storage prior to decaying and reaching a plateau, as shown by the electrochemical measurements. The observed trend was confirmed with a colorimetric assay. Uric acid had a major contribution to the extracellular AOP. Interestingly, the AOP and uric acid levels were linked to the sex of the donors. CONCLUSION The marked increase in AOP during the first week of storage suggests that RBCs are impacted early by the modification of their environment. The AOP behaviour reflects the changes in metabolism activity following the adjustment of the extracellular uric acid level. Knowing the origin, interdonor variability and the effects of the AOP on the RBCs could be beneficial for the storage quality, which will have to be further studied.
Collapse
Affiliation(s)
- M Bardyn
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - S Maye
- Laboratoire d'Electrochimie Physique et Analytique, Ecole Polytechnique Fédérale de Lausanne, EPFL Valais Wallis, Sion, Switzerland
| | - A Lesch
- Laboratoire d'Electrochimie Physique et Analytique, Ecole Polytechnique Fédérale de Lausanne, EPFL Valais Wallis, Sion, Switzerland
| | - J Delobel
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - J-D Tissot
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - F Cortés-Salazar
- Laboratoire d'Electrochimie Physique et Analytique, Ecole Polytechnique Fédérale de Lausanne, EPFL Valais Wallis, Sion, Switzerland
| | - P Tacchini
- EDEL-for-Life, Innovation Park/EPFL, Lausanne, Switzerland
| | - N Lion
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - H H Girault
- Laboratoire d'Electrochimie Physique et Analytique, Ecole Polytechnique Fédérale de Lausanne, EPFL Valais Wallis, Sion, Switzerland
| | - M Prudent
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| |
Collapse
|
33
|
Kozlova E, Chernysh A, Moroz V, Sergunova V, Gudkova O, Manchenko E. Morphology, membrane nanostructure and stiffness for quality assessment of packed red blood cells. Sci Rep 2017; 7:7846. [PMID: 28798476 PMCID: PMC5552796 DOI: 10.1038/s41598-017-08255-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 07/07/2017] [Indexed: 02/07/2023] Open
Abstract
Transfusion of packed red blood cells (PRBC) to patients in critical states is often accompanied by post-transfusion complications. This may be related with disturbance of properties of PRBC and their membranes during long-term storage in the hemopreservative solution. The purpose of our work is the study of transformation of morphology, membranes stiffness and nanostructure for assessment of PRBC quality, in vitro. By atomic force microscopy we studied the transformation of cell morphology, the appearance of topological nanodefects of membranes and by atomic force spectroscopy studied the change of membrane stiffness during 40 days of storage of PRBC. It was shown that there is a transition period (20–26 days), in which we observed an increase in the Young’s modulus of the membranes 1.6–2 times and transition of cells into irreversible forms. This process was preceded by the appearance of topological nanodefects of membranes. These parameters can be used for quality assessment of PRBC and for improvement of transfusion rules.
Collapse
Affiliation(s)
- E Kozlova
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, V.A. Negovsky Scientific Research Institute of General Reanimatology, Moscow, Russian Federation. .,Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow StateMedical University of the Ministry of Health of the Russian Federation, Moscow, Russian Federation.
| | - A Chernysh
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, V.A. Negovsky Scientific Research Institute of General Reanimatology, Moscow, Russian Federation.,Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow StateMedical University of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - V Moroz
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, V.A. Negovsky Scientific Research Institute of General Reanimatology, Moscow, Russian Federation
| | - V Sergunova
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, V.A. Negovsky Scientific Research Institute of General Reanimatology, Moscow, Russian Federation
| | - O Gudkova
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, V.A. Negovsky Scientific Research Institute of General Reanimatology, Moscow, Russian Federation
| | - E Manchenko
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, V.A. Negovsky Scientific Research Institute of General Reanimatology, Moscow, Russian Federation
| |
Collapse
|
34
|
Hod EA, Francis RO, Spitalnik SL. Red Blood Cell Storage Lesion-Induced Adverse Effects. Anesth Analg 2017; 124:1752-1754. [DOI: 10.1213/ane.0000000000001879] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
35
|
Chadebech P, Bodivit G, Razazi K, de Vassoigne C, Pellé L, Burin-des-Roziers N, Bocquet T, Bierling P, Djoudi R, Mekontso-Dessap A, Pirenne F. Red blood cells for transfusion in patients with sepsis: respective roles of unit age and exposure to recipient plasma. Transfusion 2017; 57:1898-1904. [PMID: 28568651 DOI: 10.1111/trf.14170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 04/18/2017] [Accepted: 04/18/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Red blood cell (RBC) storage in blood banks is not exempt from cellular injury. Alterations not observed on RBCs freshly isolated from units can rapidly appear in circulation. The transfusion of old blood units, even if this is a controversial issue, could therefore have adverse effects on the recipient. We wanted to determine the respective effects of storage duration and recipient plasma on RBCs for transfusion into patients with severe sepsis. STUDY DESIGN AND METHODS Eleven stored RBC units were sampled at various time points, approximately Days 3 to 8 (referred to as fresh RBCs) and Days 38 to 42 (old RBCs) and tested in coincubation experiments with plasma obtained from 13 patients with severe sepsis and 17 healthy donors as controls. RBCs were tested after 24 or 48 hours at 37°C for the detection of senescence markers (phosphatidylserine exposure, calcium influx, and reactive oxygen species detection and decrease in size) with or without exposure to plasma. RESULTS We confirmed that a 42-day refrigerated storage of RBCs alone (without any incubation in plasma) had no significant effect on RBCs and no senescence marker detected. By contrast, ex vivo exposure to plasma samples altered both fresh and old RBCs, with a much larger effect for old RBCs, regardless of the plasma used (sepsis vs. control). CONCLUSION We show that the main factor affecting the senescence of RBCs for transfusion into patients with severe sepsis is the age of the stored units rather than the clinical status of the recipient.
Collapse
Affiliation(s)
- Philippe Chadebech
- Etablissement Français du Sang Ile-de-France, site Henri-Mondor.,IMRB, U955 INSERM, équipe 2: Transfusion et Maladies du Globule Rouge, Institut Mondor, Créteil, France.,Laboratoire d'excellence GR-Ex, Paris, France
| | - Gwellaouen Bodivit
- Etablissement Français du Sang Ile-de-France, site Henri-Mondor.,IMRB, U955 INSERM, équipe 2: Transfusion et Maladies du Globule Rouge, Institut Mondor, Créteil, France.,Laboratoire d'excellence GR-Ex, Paris, France
| | - Keyvan Razazi
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, DHU A-TVB, Service de Réanimation Médicale.,Université Paris Est Créteil, Faculté de Médecine de Créteil, Groupe de Recherche CARMAS, Créteil, France
| | | | - Laurence Pellé
- Etablissement Français du Sang Ile-de-France, site de Préparation, Rungis, France
| | | | - Thibault Bocquet
- Etablissement Français du Sang Ile-de-France, site de Préparation, Rungis, France
| | | | - Rachid Djoudi
- Etablissement Français du Sang Ile-de-France, site Henri-Mondor
| | - Armand Mekontso-Dessap
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, DHU A-TVB, Service de Réanimation Médicale.,Université Paris Est Créteil, Faculté de Médecine de Créteil, Groupe de Recherche CARMAS, Créteil, France
| | - France Pirenne
- Etablissement Français du Sang Ile-de-France, site Henri-Mondor.,IMRB, U955 INSERM, équipe 2: Transfusion et Maladies du Globule Rouge, Institut Mondor, Créteil, France.,Laboratoire d'excellence GR-Ex, Paris, France.,Université Paris-Est-Créteil Val de Marne (UPEC), Créteil, France
| |
Collapse
|
36
|
|
37
|
Duration of red blood cell storage and inflammatory marker generation. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2017; 15:145-152. [PMID: 28263172 DOI: 10.2450/2017.0343-16] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 12/16/2016] [Indexed: 02/08/2023]
Abstract
Red blood cell (RBC) transfusion is a life-saving treatment for several pathologies. RBCs for transfusion are stored refrigerated in a preservative solution, which extends their shelf-life for up to 42 days. During storage, the RBCs endure abundant physicochemical changes, named RBC storage lesions, which affect the overall quality standard, the functional integrity and in vivo survival of the transfused RBCs. Some of the changes occurring in the early stages of the storage period (for approximately two weeks) are reversible but become irreversible later on as the storage is extended. In this review, we aim to decipher the duration of RBC storage and inflammatory marker generation. This phenomenon is included as one of the causes of transfusion-related immunomodulation (TRIM), an emerging concept developed to potentially elucidate numerous clinical observations that suggest that RBC transfusion is associated with increased inflammatory events or effects with clinical consequence.
Collapse
|
38
|
Bandyopadhyay S, Brittenham GM, Francis RO, Zimring JC, Hod EA, Spitalnik SL. Iron-deficient erythropoiesis in blood donors and red blood cell recovery after transfusion: initial studies with a mouse model. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2017; 15:158-164. [PMID: 28263174 PMCID: PMC5336338 DOI: 10.2450/2017.0349-16] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 12/16/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Most frequent red cell (RBC) donors and many first-time donors are iron deficient, but meet haemoglobin standards. However, the effects of donation-induced iron deficiency on RBC storage quality are unknown. Thus, we used a mouse model to determine if donor iron deficiency reduced post-transfusion RBC recovery. METHODS Weanling mice received a control diet or an iron-deficient diet. A third group receiving the iron-deficient diet was also phlebotomised weekly. This provided 3 groups of mice with different iron status: (1) iron replete, (2) mild iron deficiency with iron-deficient erythropoiesis, and (3) iron-deficiency anaemia. At ten weeks of age, blood was collected, leucoreduced, and stored at 4 ºC. After 12 days of storage, 24-hour (h) post-transfusion RBC recovery was quantified in recipients by flow cytometry. RESULTS Before blood collection, mean haemoglobin concentrations in the iron-replete, iron-deficient, and iron-deficiency anaemia donor mice were 16.5±0.4, 11.5±0.4, and 7.0±1.4 [g/dL± 1 standard deviation (SD)], respectively (p<0.01 for all comparisons between groups). The 24-h post-transfusion RBC recoveries in recipients receiving transfusions from these three cohorts were 77.1±13.2, 66.5±10.9, and 46.7±15.9 (% ±1 SD), respectively (p<0.05 for all comparisons between groups). DISCUSSION In summary, donor iron deficiency significantly reduced 24-h post-transfusion RBC recovery in recipient mice. RBCs from mice with mild iron deficiency and iron-deficient erythropoiesis, with haemoglobin levels similar to those used for human autologous blood donation, had intermediate post-transfusion RBC recovery, as compared to iron-replete donors and those with iron-deficiency anaemia. This suggests that, in addition to the effects of iron deficiency on donor health, frequent blood donation, leading to iron-deficient erythropoiesis, may also have adverse effects for transfusion recipients.
Collapse
Affiliation(s)
- Sheila Bandyopadhyay
- Department of Pathology and Cell Biology, Columbia University, New York, NY, United States of America
| | - Gary M. Brittenham
- Department of Pediatrics, Columbia University, New York, NY, United States of America
| | - Richard O. Francis
- Department of Pathology and Cell Biology, Columbia University, New York, NY, United States of America
| | - James C. Zimring
- BloodWorksNW and Departments of Laboratory Medicine and Internal Medicine, University of Washington, Seattle, WA, United States of America
| | - Eldad A. Hod
- Department of Pathology and Cell Biology, Columbia University, New York, NY, United States of America
| | - Steven L. Spitalnik
- Department of Pathology and Cell Biology, Columbia University, New York, NY, United States of America
| |
Collapse
|
39
|
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: 1.9] [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
| |
Collapse
|
40
|
Roussel C, Dussiot M, Marin M, Morel A, Ndour PA, Duez J, Le Van Kim C, Hermine O, Colin Y, Buffet PA, Amireault P. Spherocytic shift of red blood cells during storage provides a quantitative whole cell-based marker of the storage lesion. Transfusion 2017; 57:1007-1018. [PMID: 28150311 DOI: 10.1111/trf.14015] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 10/30/2016] [Accepted: 11/28/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Storage lesion may explain the rapid clearance of up to 25% of transfused red blood cells (RBCs) in recipients. Several alterations affect stored RBC but a quantitative, whole cell-based predictor of transfusion yield is lacking. Because RBCs with reduced surface area are retained by the spleen, we quantified changes in RBC dimensions during storage. STUDY DESIGN AND METHODS Using imaging flow cytometry we observed the dimension and morphology of RBCs upon storage, along with that of conventional biochemical and mechanical markers of storage lesion. We then validated these findings using differential interference contrast (DIC) microscopy and quantified the accumulation of microparticles (MPs). RESULTS Mean projected surface area of the whole RBC population decreased from 72.4 to 68.4 µm2 , a change resulting from the appearance of a well-demarcated subpopulation of RBCs with reduced mean projected surface (58 µm2 , 15.2%-19.9% reduction). These "small RBCs" accounted for 4.9 and 23.6% of all RBCs on Days 3 and 42 of storage, respectively. DIC microscopy confirmed that small RBCs had shifted upon storage from discocytes to echinocytes III, spheroechinocytes, and spherocytes. Glycophorin A-positive MPs and small RBCs appeared after similar kinetics. CONCLUSION The reduction in surface area of small RBCs is expected to induce their retention by the spleen. We propose that small RBCs generated by MP-induced membrane loss are preferentially cleared from the circulation shortly after transfusion of long-stored blood. Their operator-independent quantification using imaging flow cytometry may provide a marker of storage lesion potentially predictive of transfusion yield.
Collapse
Affiliation(s)
- Camille Roussel
- Université Sorbonne Paris Cité, Université Paris Descartes, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge.,Université Sorbonne Paris Cité, Université Paris Descartes, Inserm, CNRS, Institut Imagine, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutic Implications, Laboratoire d'Excellence GR-Ex
| | - Michaël Dussiot
- Université Sorbonne Paris Cité, Université Paris Descartes, Inserm, CNRS, Institut Imagine, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutic Implications, Laboratoire d'Excellence GR-Ex
| | - Mickaël Marin
- Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge
| | - Alexandre Morel
- Université Sorbonne Paris Cité, Université Paris Descartes, Inserm, CNRS, Institut Imagine, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutic Implications, Laboratoire d'Excellence GR-Ex
| | - Papa Alioune Ndour
- Université Sorbonne Paris Cité, Université Paris Descartes, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge
| | - Julien Duez
- Université Sorbonne Paris Cité, Université Paris Descartes, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge
| | - Caroline Le Van Kim
- Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge
| | - Olivier Hermine
- Université Sorbonne Paris Cité, Université Paris Descartes, Inserm, CNRS, Institut Imagine, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutic Implications, Laboratoire d'Excellence GR-Ex.,Department of Adult Hematology, Necker Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Yves Colin
- Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge
| | - Pierre A Buffet
- Université Sorbonne Paris Cité, Université Paris Descartes, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge
| | - Pascal Amireault
- Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge.,Université Sorbonne Paris Cité, Université Paris Descartes, Inserm, CNRS, Institut Imagine, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutic Implications, Laboratoire d'Excellence GR-Ex
| |
Collapse
|
41
|
Antonelou MH, Seghatchian J. Insights into red blood cell storage lesion: Toward a new appreciation. Transfus Apher Sci 2016; 55:292-301. [PMID: 27839967 DOI: 10.1016/j.transci.2016.10.019] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Red blood cell storage lesion (RSL) is a multifaceted biological phenomenon. It refers to deterioration in RBC quality that is characterized by lethal and sub-lethal, reversible and irreversible defects. RSL is influenced by prestorage variables and it might be associated with variable clinical outcomes. Optimal biopreservation conditions are expected to offer maximum levels of RBC survival and acceptable functionality and bioreactivity in-bag and in vivo; consequently, full appraisal of RSL requires understanding of how RSL changes interact with each other and with the recipient. Recent technological innovation in MS-based omics, imaging, cytometry, small particle and systems biology has offered better understanding of RSL contributing factors and effects. A number of elegant in vivo and in vitro studies have paved the way for the identification of quality control biomarkers useful to predict RSL profile and posttransfusion performance. Moreover, screening tools for the early detection of good or poor "storers" and donors have been developed. In the light of new perspectives, storage time is not the touchstone to rule on the quality of a packed RBC unit. At least by a biochemical standpoint, the metabolic aging pattern during storage may not correspond to the currently fresh/old distinction of stored RBCs. Finally, although each unit of RBCs is probably unique, a metabolic signature of RSL across storage variables might exist. Moving forward from traditional hematologic measures to integrated information on structure, composition, biochemistry and interactions collected in bag and in vivo will allow identification of points for intervention in a transfusion meaningful context.
Collapse
Affiliation(s)
- Marianna H Antonelou
- Department of Biology, School of Science, National and Kapodistrian University of Athens (NKUA), Athens, Greece.
| | - Jerard Seghatchian
- International Consultancy in Blood Component Quality/Safety Improvement, Audit/Inspection and DDR Strategy, London, UK.
| |
Collapse
|
42
|
Francis RO, Spitalnik SL. Red blood cell components: Meeting the quantitative and qualitative transfusion needs. Presse Med 2016; 45:e281-8. [PMID: 27476016 DOI: 10.1016/j.lpm.2016.06.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Red blood cell (RBC) transfusion is a very common therapeutic intervention. However, because of multiple recent studies improving our understanding of appropriate transfusion scenarios, the total number of RBC units transfused per year is actually decreasing in the developed world and there are no longer major shortages of RBC products for general use. Nonetheless, there are an increasing number of "special" uses, which can put strains on the blood supply for particular types of products; these may produce shortages of specific types of RBCs or require collections targeting certain types of donors. This review will focus on several broad topics, including providing some examples of "special" settings that require, or could require, special types of RBC products.
Collapse
Affiliation(s)
- Richard O Francis
- Laboratory of Transfusion Biology, Department of Pathology and Cell Biology, Columbia University, 630 West 168th Street, Room P&S 14-434, New York, New York 10032, USA
| | - Steven L Spitalnik
- Laboratory of Transfusion Biology, Department of Pathology and Cell Biology, Columbia University, 630 West 168th Street, Room P&S 14-434, New York, New York 10032, USA.
| |
Collapse
|
43
|
Tzounakas VL, Kriebardis AG, Papassideri IS, Antonelou MH. Donor-variation effect on red blood cell storage lesion: A close relationship emerges. Proteomics Clin Appl 2016; 10:791-804. [PMID: 27095294 DOI: 10.1002/prca.201500128] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 03/24/2016] [Accepted: 04/11/2016] [Indexed: 12/20/2022]
Abstract
Although the molecular pathways leading to the progressive deterioration of stored red blood cells (RBC storage lesion) and the clinical relevance of storage-induced changes remain uncertain, substantial donor-specific variability in RBC performance during storage, and posttransfusion has been established ("donor-variation effect"). In-bag hemolysis and numerous properties of the RBC units that may affect transfusion efficacy have proved to be strongly donor-specific. Donor-variation effect may lead to the production of highly unequal blood labile products even when similar storage strategy and duration are applied. Genetic, undiagnosed/subclinical medical conditions and lifestyle factors that affect RBC characteristics at baseline, including RBC lifespan, energy metabolism, and sensitivity to oxidative stress, are all likely to influence the storage capacity of individual donors' cells, although not evident by the donor's health or hematological status at blood donation. Consequently, baseline characteristics of the donors, such as membrane peroxiredoxin-2 and serum uric acid concentration, have been proposed as candidate biomarkers of storage quality. This review article focuses on specific factors that might contribute to the donor-variation effect and emphasizes the emerging need for using omics-based technologies in association with in vitro and in vivo transfusion models and clinical trials to discover biomarkers of storage quality and posttransfusion recovery in donor blood.
Collapse
Affiliation(s)
- Vassilis L Tzounakas
- Department of Cell Biology and Biophysics, Faculty of Biology, NKUA, Athens, Greece
| | - Anastasios G Kriebardis
- Department of Medical Laboratories, Faculty of Health and Caring Professions, Technological and Educational Institute of Athens, Greece
| | | | - Marianna H Antonelou
- Department of Cell Biology and Biophysics, Faculty of Biology, NKUA, Athens, Greece
| |
Collapse
|
44
|
Pertinhez TA, Casali E, Baroni F, Berni P, Baricchi R, Spisni A. A Comparative Study of the Effect of Leukoreduction and Pre-storage Leukodepletion on Red Blood Cells during Storage. Front Mol Biosci 2016; 3:13. [PMID: 27148539 PMCID: PMC4839302 DOI: 10.3389/fmolb.2016.00013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 03/24/2016] [Indexed: 11/24/2022] Open
Abstract
Blood transfusion is a fundamental therapy in numerous pathological conditions. Regrettably, many clinical reports describe adverse transfusion's drawbacks due to red blood cells alterations during storage. Thus, the possibility for a blood bank to ameliorate the quality of the erythrocyte concentrates units is crucial to improve clinical results and reduce transfusion adverse occurrences. Leukodepletion is a pre-storage treatment recognized to better preserve the quality of red blood cells with respect to leukoreduction. Aim of this work is to unravel the biochemical and biophysical basis that sustain the good clinical outcomes associated to the use of leukodepleted erythrocytes units. Erythrocytes concentrates were prepared as leukoreduced (n = 8) and pre-storage leukodepleted (n = 8) and then studied during 6 weeks in blood bank conditions. Overall, the data indicate that leukodepletion not only provide red blood cells with an appropriate amount of nutrients for a longer time but also selects red blood cells characterized by a more resilient plasma membrane fit to prolong their viability. We believe these results will stimulate new ideas to further optimize the current storage protocols.
Collapse
Affiliation(s)
- Thelma A Pertinhez
- Transfusion Medicine Unit, Arcispedale Santa Maria Nuova - IRCCSReggio Emilia, Italy; Department of Biomedical, Biotechnological and Translational Sciences, University of ParmaParma, Italy
| | - Emanuela Casali
- Department of Biomedical, Biotechnological and Translational Sciences, University of Parma Parma, Italy
| | - Fabio Baroni
- Transfusion Medicine Unit, Arcispedale Santa Maria Nuova - IRCCS Reggio Emilia, Italy
| | - Pamela Berni
- Transfusion Medicine Unit, Arcispedale Santa Maria Nuova - IRCCS Reggio Emilia, Italy
| | - Roberto Baricchi
- Transfusion Medicine Unit, Arcispedale Santa Maria Nuova - IRCCS Reggio Emilia, Italy
| | - Alberto Spisni
- Department of Surgical Sciences, University of Parma Parma, Italy
| |
Collapse
|
45
|
Prudent M, Stauber F, Rapin A, Hallen S, Pham N, Abonnenc M, Marvin L, Rochat B, Tissot JD, Lion N. Small-Scale Perfusion Bioreactor of Red Blood Cells for Dynamic Studies of Cellular Pathways: Proof-of-Concept. Front Mol Biosci 2016; 3:11. [PMID: 27066491 PMCID: PMC4812044 DOI: 10.3389/fmolb.2016.00011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 03/09/2016] [Indexed: 01/17/2023] Open
Abstract
To date, the development of bioreactors for the study of red blood cells (RBCs, daily transfused in the case of disease or hemorrhage) has focused on hematopoietic stem cells. Despite the fact that mature RBCs are enucleated and do not expand, they possess complex cellular and metabolic pathways, as well as post-translation modification signaling and gas-exchange regulation. In order to dynamically study the behavior of RBCs and their signaling pathways under various conditions, a small-scale perfusion bioreactor has been developed. The most advanced design developed here consists of a fluidized bed of 7.6 mL containing 3·109 cells and perfused at 8.5 μL/min. Mimicking RBC storage conditions in transfusion medicine, as a proof-of-concept, we investigated the ex vivo aging of RBCs under both aerobic and anaerobic conditions. Hence, RBCs stored in saline-adenine-glucose-mannitol (SAGM) were injected in parallel into two bioreactors and perfused with a modified SAGM solution over 14 days at room temperature under air or argon. The formation of a fluidized bed enabled easy sampling of the extracellular medium over the storage period used for the quantitation of glucose consumption and lactate production. Hemolysis and microvesiculation increased during aging and were reduced under anaerobic (argon) conditions, which is consistent with previously reported findings. Glucose and lactate levels showed expected trends, i.e., decreased and increased during the 2-week period, respectively; whereas extracellular glucose consumption was higher under aerobic conditions. Metabolomics showed depletion of glycolsis and pentose phosphate pathway metabolites, and an accumulation of purine metabolite end-products. This novel approach, which takes advantage of a fluidized bed of cells in comparison to traditional closed bags or tubes, does not require agitation and limit shear stress, and constantly segragates extracellular medium from RBCs. It thus gives access to several difficult-to-obtain on- and off-line parameters in the extracellular medium. This dynamic bioreactor system does not only allow us to probe the behavior of RBCs under different storage conditions, but it also could be a powerful tool to study physiological or pathological RBCs exposed to various conditions and stimuli.
Collapse
Affiliation(s)
- Michel Prudent
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement, Transfusion Interrégionale CRS Epalinges, Switzerland
| | - Frédéric Stauber
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement, Transfusion Interrégionale CRS Epalinges, Switzerland
| | - Alexis Rapin
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement, Transfusion Interrégionale CRS Epalinges, Switzerland
| | - Sonia Hallen
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement, Transfusion Interrégionale CRS Epalinges, Switzerland
| | - Nicole Pham
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement, Transfusion Interrégionale CRS Epalinges, Switzerland
| | - Mélanie Abonnenc
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement, Transfusion Interrégionale CRS Epalinges, Switzerland
| | - Laure Marvin
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement, Transfusion Interrégionale CRSEpalinges, Switzerland; Quantitative Mass Spectrometry Facility, Centre Hospitalier Universitaire Vaudois (CHUV)Lausanne, Switzerland
| | - Bertrand Rochat
- Quantitative Mass Spectrometry Facility, Centre Hospitalier Universitaire Vaudois (CHUV) Lausanne, Switzerland
| | - Jean-Daniel Tissot
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement, Transfusion Interrégionale CRS Epalinges, Switzerland
| | - Niels Lion
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement, Transfusion Interrégionale CRS Epalinges, Switzerland
| |
Collapse
|
46
|
Sarhangian V, Abouee-Mehrizi H, Baron O, Berman O, Heddle NM, Barty R. Reducing the age of transfused red blood cells in hospitals: ordering and allocation policies. Vox Sang 2016; 110:385-92. [PMID: 26848721 DOI: 10.1111/vox.12374] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 11/30/2015] [Accepted: 12/02/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND Although recent randomized controlled trials have not found increased risk of morbidity/mortality with older red blood cells (RBCs), several large trials will be completed soon providing power to detect smaller risks if indeed they exist. Hence, there may still be a need for inventory management policies that could reduce the age of transfused RBCs without compromising availability or resulting in excessive outdates. MATERIALS AND METHODS We developed a computer simulation model based on data from an acute care hospital in Hamilton, Ontario. We evaluated and compared the performance of certain practical ordering and allocation policies in terms of outdate rate, shortage rate and the distribution of the age of issued RBCs. RESULTS During the 1-year period for which we analysed the data, 10349 RBC units were transfused with an average issue age of 20·7 days and six units were outdated (outdate rate: 0·06%). Adopting a strict first in, first out (FIFO) allocation policy and an order-up-to ordering policy with target levels set to five times the estimated daily demand for each blood type, reduced the average issue age by 29·4% (to 14·6 days), without an increase in the outdate rate (0·05%) or resulting in any unmet demand. Further reduction of issue age without a significant increase in outdate rate was observed when adopting non-FIFO threshold-based allocation policies and appropriately adjusting the order-up-to levels. CONCLUSION A significant reduction of issue age could be possible, without compromising availability or resulting in excessive outdates, by properly adjusting the ordering and allocation policies at the hospital level.
Collapse
Affiliation(s)
- V Sarhangian
- Rotman School of Management, University of Toronto, Toronto, ON, Canada
| | - H Abouee-Mehrizi
- Department of Management Sciences, University of Waterloo, Waterloo, ON, Canada
| | - O Baron
- Rotman School of Management, University of Toronto, Toronto, ON, Canada
| | - O Berman
- Rotman School of Management, University of Toronto, Toronto, ON, Canada
| | - N M Heddle
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - R Barty
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
47
|
Delobel J, Prudent M, Tissot JD, Lion N. Proteomics of the red blood cell carbonylome during blood banking of erythrocyte concentrates. Proteomics Clin Appl 2016; 10:257-66. [PMID: 26548766 DOI: 10.1002/prca.201500074] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/09/2015] [Accepted: 11/03/2015] [Indexed: 12/13/2022]
Abstract
PURPOSE Transfusion of red blood cells (RBCs) is a daily medical procedure. Erythrocyte concentrates (ECs) can be stored up to 56 days at 4 °C in saline additive solution mainly composed of adenine and sugar. Such nonphysiological conditions induce the occurrence of storage lesions, such as alterations of metabolism, protein oxidation, and deterioration of rheological properties. Their accumulation tends to decrease the main EC therapeutic property, that is, the oxygenation capacity. Protein carbonylation is a marker of oxidative stress and aging, and its occurrence during RBC storage was earlier characterized as a time-dependent and cellular compartment dependent modification. EXPERIMENTAL DESIGN Three ECs from independent donations were followed. The carbolynome was here characterized in soluble and membrane extracts (n-dodecyl β-D-maltoside-based extraction buffer) of RBCs stored for 6, 27, and 41 days, through biotin hydrazide derivatization, biotin-avidin affinity purification, SDS-PAGE separation, and LC-MS/MS analyses. RESULTS A total of 142 and 20 proteins were identified as carbonylated in soluble and membrane extracts, respectively. Particularly, a time-dependent evolution of 26.8% of the soluble carbonylome was observed. CONCLUSIONS AND CLINICAL RELEVANCE Affected cellular mechanisms involve antioxidant defenses, metabolism pathways, and proteasomal degradation. To better store RBCs those functions have to be preserved, which opens new routes of investigation in transfusion medicine.
Collapse
Affiliation(s)
- Julien Delobel
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS SA, Epalinges, Switzerland
| | - Michel Prudent
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS SA, Epalinges, Switzerland
| | - Jean-Daniel Tissot
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS SA, Epalinges, Switzerland
| | - Niels Lion
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS SA, Epalinges, Switzerland
| |
Collapse
|
48
|
Delobel J, Garraud O, Barelli S, Lefrère JJ, Prudent M, Lion N, Tissot JD. Storage lesion: History and perspectives. World J Hematol 2015; 4:54-68. [DOI: 10.5315/wjh.v4.i4.54] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 09/01/2015] [Accepted: 10/19/2015] [Indexed: 02/05/2023] Open
Abstract
Red blood cell concentrates (RBCCs) are the major labile blood component transfused worldwide to rescue severe anemia symptoms. RBCCs are frequently stored in additive solutions at 4 °C for up to 42 d, which induces cellular lesion and alters red blood cell metabolism, protein content, and rheological properties. There exists a hot debate surrounding the impact of storage lesion, with some uncertainty regarding how RBCC age may impact transfusion-related adverse clinical outcomes. Several studies show a tendency for poorer outcomes to occur in patients receiving older blood products; however, no clear significant association has yet been demonstrated. Some age-related RBCC alterations prove reversible, while other changes are irreversible following protein oxidation. It is likely that any irreversible damage affects the blood component quality and thus the transfusion efficiency. The present paper aims to promote a better understanding of the occurrence of red blood cell storage lesion, with particular focus on biochemical changes and microvesiculation, through a discussion of the historical advancement of blood transfusion processes.
Collapse
|
49
|
Prudent M, Crettaz D, Delobel J, Seghatchian J, Tissot JD, Lion N. Differences between calcium-stimulated and storage-induced erythrocyte-derived microvesicles. Transfus Apher Sci 2015; 53:153-8. [PMID: 26549671 DOI: 10.1016/j.transci.2015.10.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Microvesicles (MVs), or microparticles, are a complex, dynamic and functional part of cells. Red blood cell (RBC)-derived MVs are naturally produced in vivo (during normal aging processes or in several diseases) as well as ex vivo during cold storage of RBCs, or in vitro by ATP depletion or treatment with Ca(2+) and calcium ionophore. All these MVs are equivalently classified according to their size and/or surface markers. Nevertheless, their content in proteins can differ and a few differences in terms of lipid raft proteins, notably stomatin and flotillin-2, have been reported. Based on two-dimensional gel electrophoreses, the present study highlights the differences between MVs induced during storage of RBCs (storage-MVs) and MVs stimulated by Ca(2+) entry (Ca-MVs). Upon treatment, Ca-MVs are formed following a clear recruitment of Ca(2+)-binding proteins (sorcin, grancalcin, PDCD6) and particularly annexins (4 and 5). Therefore, it emerges that different molecular pathways are available to produce similar MVs by disturbing the membrane/cytoskeleton interactions. Interestingly, these differences provide non-negligible pieces of information on the parent cells, and the mechanisms and modes of actions involved in the formation of MVs. In addition to biophysical characterization, protein analysis is important to classify these cellular corpuscles and evaluate their potential impacts in diseases or transfusion medicine.
Collapse
Affiliation(s)
- Michel Prudent
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - David Crettaz
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - Julien Delobel
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - Jerard Seghatchian
- International Consultancy in Blood Components Quality/Safety, Audit/Inspection and DDR Strategy, London, UK
| | - Jean-Daniel Tissot
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - Niels Lion
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland.
| |
Collapse
|