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Kalmukov IA, Galliano A, Godolphin J, Ferreira R, Cardoso I, Norgate DJ, Bacon NJ. Ex vivo evaluation of a novel cell salvage device to recover canine erythrocytes. Vet Surg 2022; 51:1223-1230. [PMID: 36062370 DOI: 10.1111/vsu.13875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 06/14/2022] [Accepted: 07/14/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the ability of a cell salvage device to recover canine erythrocytes by direct aspiration of diluted packed red blood cells (pRBC) and saline rinse from blood-soaked surgical swabs. STUDY DESIGN Experimental study. SAMPLE POPULATION Twelve recently expired units of canine pRBC. METHODS pRBC units donated from a pet blood bank (after quality analysis) were diluted with anticoagulant, divided into two equal aliquots, and subsequently harvested by direct suction (Su), or soaked into swabs, saline-rinsed and suctioned (Sw). The volume of product, manual packed cell volume (PCV), and red blood cell mass (rbcM) were measured and compared before and after salvaging. The rbcM recovery was recorded as percentage ([rbcM post salvage]/[rbcM presalvage]x100). Statistical analysis of all measured values was performed (significance p < .05). RESULTS No difference was detected between pre- and post-salvage PCV or mean rise of PCV for either group. The volume of salvaged blood was 143 ml (SD ± 2.89 ml; Su) and 139.83 ml (SD ± 3.30 ml; Sw), p < .001. The average rbcM recovered was 88.43% (Su) and 84.74%. (Sw) averaged 84.74% (p = .015). Blood type and order of processing did not influence recovery. CONCLUSION The tested cell saver device reliably salvages canine blood in this ex vivo setting. Cell salvage via direct suction produces higher volumes of salvaged blood than rinsing blood-soaked swabs and salvaging the flush. CLINICAL SIGNIFICANCE Washing blood-saturated surgical swabs results in a high harvest of red blood cells. The authors recommend it as an adjunct to direct suction to maximize erythrocyte recovery.
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Affiliation(s)
- Ivan A Kalmukov
- Fitzpatrick Referrals Oncology and Soft Tissue, Guildford, UK
| | - Andrea Galliano
- Fitzpatrick Referrals Oncology and Soft Tissue, Guildford, UK
| | - Janet Godolphin
- Department of Mathematics, University of Surrey, Guildford, UK
| | | | | | - Daisy J Norgate
- Fitzpatrick Referrals Oncology and Soft Tissue, Guildford, UK
| | - Nicholas J Bacon
- Fitzpatrick Referrals Oncology and Soft Tissue, Guildford, UK.,Department of Veterinary Medicine, University of Surrey, Guildford, UK
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2
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Davidow EB, Montgomery H, Mensing M. The influence of leukoreduction on the acute transfusion-related complication rate in 455 dogs receiving 730 packed RBCs: 2014-2017. J Vet Emerg Crit Care (San Antonio) 2022; 32:479-490. [PMID: 35043550 DOI: 10.1111/vec.13175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/22/2020] [Accepted: 07/25/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the influence of prestorage leukoreduction of packed RBCs (pRBCs) on acute transfusion-related complication rate in dogs. SETTING Two private referral hospitals. DESIGN Retrospective case study. ANIMALS Four hundred and fifty-five dogs receiving nonleukoreduced (nLR) or leukoreduced (LR) pRBC between January 1, 2014 and July 31, 2017. MEASUREMENTS AND MAIN RESULTS Transfusions were retrospectively reviewed to record data about the patient, donor, unit, transfusion event, acute complications, hospital discharge, and cause of death. Of 730 transfusion events in 455 dogs, 288 used LR pRBC and 442 used nLR pRBC. There was a 18.9% (138/730) overall complication rate. Seven (0.96%) complications were life-threatening. The most common complications were pyrexia (5.6%), gastrointestinal signs (4.9%), and hemolysis with no other signs (4.1%). Pyrexia with no other clinical signs, consistent with a febrile nonhemolytic transfusion reaction (FNHTR), occurred in 3.2% of transfusion events. There was a significant (P = 0.03) decrease in the rate of FNHTR with LR pRBC (1%) versus nLR pRBC (4.5%). Use of LR pRBC did not decrease in-hospital mortality. The odds of any complication, hemolysis only, FNHTR, and more severe complications increased with pRBC age. Leukoreduction did not decrease the impact of pRBC age on these complications. Use of older pRBC did not increase the incidence of life-threatening complications or mortality. Dogs receiving pRBC for blood loss were more likely to have gastrointestinal and more severe complications than those dogs that had hemolysis. The effect of pRBC unit age on complications was not influenced by the underlying reason for transfusion. Dogs that received a previous transfusion were more likely to have respiratory complications. CONCLUSION In this study, the use of LR pRBC was associated with a decreased rate of FNHTR but no other complications. Unit age was associated with the incidence of hemolysis, FNHTR, and complication severity but not the rate of life-threatening complications or mortality.
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Affiliation(s)
| | - Heather Montgomery
- ACCES Blood Bank, BluePearl Veterinary Partners, Seattle, Washington, USA
| | - Michelle Mensing
- ACCES Blood Bank, BluePearl Veterinary Partners, Seattle, Washington, USA
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Trinder RD, Lo E, Humm KR. The effects of leukoreduction on canine blood unit weight and processing time. J Vet Emerg Crit Care (San Antonio) 2022; 32:836-839. [PMID: 35712893 PMCID: PMC9796084 DOI: 10.1111/vec.13225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 04/13/2021] [Accepted: 05/29/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Despite a lack of strong evidence of benefit, leukoreduction is employed to decrease the risk of leukocyte-induced transfusion reactions. However, the impact of leukoreduction on blood bank costs and inventory management is not well understood. The purpose of this study was to determine whether leukoreduction of whole blood increases total processing time and weight loss from packed red blood cells (PRBCs) and plasma relative to bags created from nonleukoreduced whole blood. KEY FINDINGS A total of 68 canine whole blood collections were divided equally into leukoreduced and nonleukoreduced groups (N = 34 in each). There was no significant difference between groups in mean PRBC or plasma unit weights or processing times. Leukoreduced PRBC bags lost a significantly greater proportion of weight during processing than did nonleukoreduced PRBC bags (P < 0.01), which is attributed to red and white blood cells lost in the filtration process. SIGNIFICANCE Leukoreduction did not lead to a significant increase in processing times or smaller PRBCs or plasma bags compared to nonleukoreduced bags. The blood remaining in the leukoreduction filter following filtration is primarily composed of red blood cells, with minimal plasma retained.
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Affiliation(s)
- Richard D. Trinder
- Department of Clinical Science and Services, The Royal Veterinary CollegeUniversity of LondonNorth MymmsHertfordshireUK
| | - Eva Lo
- Attimore Veterinary HospitalWelwyn Garden CityHertfordshireUK
| | - Karen R. Humm
- Department of Clinical Science and Services, The Royal Veterinary CollegeUniversity of LondonNorth MymmsHertfordshireUK
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4
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Frank MJ, Khattab MR, Wills RW, Archer TM, Mackin AJ, Suchodolski JS, Lidbury JA, Steiner JM, Sullivant AM, Thomason JM. Effects of leukoreduction on N-methylhistamine concentration in stored units of canine whole blood. Am J Vet Res 2021; 82:890-896. [PMID: 34669495 DOI: 10.2460/ajvr.82.11.890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the effects of leukoreduction on N-methylhistamine (NMH; a stable histamine metabolite) concentration in units of canine whole blood during storage and incubation at room temperature (approx 22 °C) to simulate temperature conditions during transfusion. ANIMALS 8 healthy adult Walker Hounds. PROCEDURES A standard unit of blood (450 mL) was obtained from each dog twice, with at least 28 days between donations. Blood units collected from 4 dogs during the first donation underwent leukoreduction, whereas the blood units collected from the other 4 dogs did not undergo leukoreduction, prior to storage at 4 °C. The alternate treatment was applied to blood units collected during the second donation. A sample from each unit was obtained for determination of plasma NMH concentration the day of donation (before and after leukoreduction when applicable) and before and after incubation at room temperature for 5 hours on days 14 and 28 of storage. RESULTS Units that underwent leukoreduction had substantially lower leukocyte and platelet counts than nonleukoreduced units. Plasma NMH concentration increased immediately after leukoreduction but did not change significantly during the subsequent 28 days of storage, nor did it differ between units that did and did not undergo leukoreduction. CONCLUSIONS AND CLINICAL RELEVANCE Leukoreduction and simulated transfusion temperature did not affect the histamine load in units of canine whole blood during the first 28 days of storage. Further research is necessary to determine whether histamine contributes to the development and severity of blood transfusion reactions in dogs.
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Affiliation(s)
- Mariah J Frank
- From the Atlantic Veterinary Internal Medicine and Oncology Hospital, Towson, MD 21286
| | - Mohammad R Khattab
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843
| | - Robert W Wills
- Departments of Comparative Biomedical Sciences and Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762
| | - Todd M Archer
- Departments of Comparative Biomedical Sciences and Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762
| | - Andrew J Mackin
- Departments of Comparative Biomedical Sciences and Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843
| | - Jonathan A Lidbury
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843
| | - Joerg M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843
| | - Alyssa M Sullivant
- Departments of Comparative Biomedical Sciences and Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762
| | - John M Thomason
- Departments of Comparative Biomedical Sciences and Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762
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Spada E, Perego R, Baggiani L, Proverbio D. Effect of Leukoreduction by Pre-Storage Filtration on Coagulation Activity of Canine Plasma Collected for Transfusion. Vet Sci 2021; 8:vetsci8080157. [PMID: 34437479 PMCID: PMC8402778 DOI: 10.3390/vetsci8080157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/29/2021] [Accepted: 08/03/2021] [Indexed: 12/16/2022] Open
Abstract
Leukoreduction of blood products is a technique used to prevent leukocyte-induced transfusion reactions and is extensively used in human, but rarely in veterinary patients. The concentration of some coagulation proteins can be affected by the processing steps used for the preparation of leuko-reduced plasma units. In this study, we assessed the effect of leukoreduction on coagulation activity of canine plasma collected for transfusion. Ten plasma units, five obtained from non-leuko-reduced (non-LR) whole blood (WB) units and five from leuko-reduced (LR) WB units were evaluated. Prothrombin time (PT), activated partial thromboplastin time (aPTT), coagulation factor activities of factors (F) V, VIII, X, XI, and von Willebrand (vWF), fibrinogen and D-dimers content were assessed at collection (baseline value, D0) and after 7 days of frozen storage at −18 °C (D7). Compared to non-LR plasma units, LR units showed a statistically significant prolonged aPTT and reduced FXI activity. Filtration had no significant effect on the other factors and parameters evaluated. Filtration-dependent changes appear to have no impact on the therapeutic quality of plasma obtained from leuko-reduced whole blood, other than for FXI activity. Further studies on a larger sample size comparing the same unit before and after leukoreduction are needed to confirm these findings.
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Radulescu SM, Skulberg R, McDonald C, Chan DL, Humm K. Randomized double-blinded clinical trial on acute transfusion reactions in dogs receiving leukoreduced versus nonleukoreduced packed red blood cells. J Vet Intern Med 2021; 35:1325-1332. [PMID: 33960540 PMCID: PMC8162603 DOI: 10.1111/jvim.16138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/09/2021] [Accepted: 04/15/2021] [Indexed: 12/14/2022] Open
Abstract
Background Leukoreduction of blood products is commonly performed in human medicine, but its effect on outcome or incidence of transfusion reactions (TRs) in dogs is unknown. Objectives To prospectively evaluate the incidence of acute TRs in, and the outcome of, dogs receiving either leukoreduced (LR) or nonleukoreduced (N‐LR) packed red blood cells (PRBC). Animals Dogs (n = 194) administered PRBC between August 2017 and June 2020. Methods Prospective randomized double‐blinded clinical trial. Dogs were randomized to receive either LR or N‐LR PRBC and clinicians, nurses and investigators were blinded to the group allocations. The incidence of TRs, change in PCV, hospitalization duration, and survival to discharge were recorded. Results Out of the 194 dogs, 96 received LR and 98 received N‐LR PRBCs. The mean 12‐hour change in PCV value was +9.22% (SD 5.27%) for dogs that received N‐LR and +10.69% (SD 6.44%) for dogs that received LR PRBC (effect size 0.26, 95% confidence interval [CI] −0.02 to 0.55), which was not significantly different (P = .08). TRs were documented in 16/194 (8.24%) dogs, with 1/194 (0.51%) being a mild allergic reaction, while 15/194 (7.73%) had suspected febrile nonhemolytic TRs (FNHTRs). FNHTR incidence was not significantly different between the LR (6/96, 6.25%, 95% CI 2.8‐13.56) and N‐LR (9/98, 9.18%, 95% CI 4.92‐17.11) groups (P = .81). Of the 156 dogs that survived to discharge, 80/156 received N‐LR PRBC and 76/156 received LR PRBC which was not significantly different (P = .66). Conclusions and Clinical Importance A clinical advantage of using LR over N‐LR PRBC in terms of TRs and increase in PCV after transfusion was not detected.
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Affiliation(s)
- Sinziana Maria Radulescu
- Department of Clinical Sciences and Services, The Royal Veterinary College, North Mymms, Herts, United Kingdom
| | - Ragnhild Skulberg
- Department of Clinical Sciences and Services, The Royal Veterinary College, North Mymms, Herts, United Kingdom.,Small Animal Section, Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Ås, Norway
| | - Charlotte McDonald
- Department of Clinical Sciences and Services, The Royal Veterinary College, North Mymms, Herts, United Kingdom.,Dick White Referrals, Station Farm, Cambridgeshire, United Kingdom
| | - Daniel L Chan
- Department of Clinical Sciences and Services, The Royal Veterinary College, North Mymms, Herts, United Kingdom
| | - Karen Humm
- Department of Clinical Sciences and Services, The Royal Veterinary College, North Mymms, Herts, United Kingdom
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Antognoni MT, Marenzoni ML, Misia AL, Avellini L, Chiaradia E, Gavazza A, Miglio A. Effect of Leukoreduction on Hematobiochemical Parameters and Storage Hemolysis in Canine Whole Blood Units. Animals (Basel) 2021; 11:ani11040925. [PMID: 33805143 PMCID: PMC8064101 DOI: 10.3390/ani11040925] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 01/28/2023] Open
Abstract
Simple Summary During the storage of blood units, cells undergo many changes, defined as storage lesions; these are biochemical, morphological and immunological modifications and seem to be responsible for adverse post-transfusion effects in recipients. The pre-storage leukoreduction seems to reduce them. The aims of this study are both to evaluate the human filter effectiveness and the effect of pre-storage leukoreduction in stored canine whole blood units. We tested whole blood units, leukoreduced and not, obtained from seven enrolled subjects, until the 42nd day. The white blood cell (WBC) and platelet (PLT) counts are reported to express the leukoreduction effectiveness. As indicators of storage-induced hemolysis, the lactate dehydrogenase activity (LDH) and sodium, potassium, and chlorine electrolytes were measured in plasma, and the red blood cell (RBC) count, hemoglobin concentration (Hgb), and hematocrit (Hct) were obtained with the complete blood count (CBC). The mean corpuscular volume (MCV) values and morphological index obtained from blood smear evaluation were used as indices of morphological changes. We observed that the leukoreduction filter for human use is equally effective on canine whole blood and that leukoreduction has a partially protective role to prevent some storage lesions. Abstract Storage lesions (SLs) occur when the red blood cell quality is altered during the preservation of blood units. Pre-storage leukoreduction would limit the number of SLs. The aims of this study were to evaluate the effectiveness of a leukoreduction filter for human use and the effect of pre-storage leukoreduction on some ematobiochemical parameters in stored canine whole blood. Seven canine blood units were tested. Each one was divided into two units—one leukoreduced (LRWB) and one non-leukoreduced (nLRWB). On each unit, we determined the complete blood count (CBC), lactate-dehydrogenase (LDH), electrolytes (Na+, K+, Cl−), morphological index (MI) and hemolysis, on storage days 0, 7, 14, 21, 28, 35, and 42. Leukoreduction allowed a 98.30% recovery of the RBC count, retaining 99.69% and 94.91% of WBCs and PLTs, respectively. We detected a significant increase of LDH and MI with strongly higher values in nLRWB compared to LRWB. A progressive increase in electrolytes and LDH concentrations was observed as indices of stored hemolysis. LDH showed significantly lower values in LRWB units compared to nLRWB, suggesting its release from leukocytes. In the majority of units, hemolysis reached 1% on the 42nd day of storage. We assert the human leukoreduction filter effectiveness on canine whole blood, and we recommend using nLRWB before day 14, especially for critically ill patients. The difference of the basal hemolysis (day 0) percentages observed between subjects suggests that more studies should be performed to confirm a possible inter-individual donor biological variability of RBC membrane resistance, as happens in humans.
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Affiliation(s)
- Maria Teresa Antognoni
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (M.T.A.); (M.L.M.); (A.L.M.); (L.A.); (E.C.)
| | - Maria Luisa Marenzoni
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (M.T.A.); (M.L.M.); (A.L.M.); (L.A.); (E.C.)
| | - Ambra Lisa Misia
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (M.T.A.); (M.L.M.); (A.L.M.); (L.A.); (E.C.)
| | - Luca Avellini
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (M.T.A.); (M.L.M.); (A.L.M.); (L.A.); (E.C.)
| | - Elisabetta Chiaradia
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (M.T.A.); (M.L.M.); (A.L.M.); (L.A.); (E.C.)
| | - Alessandra Gavazza
- School of Bioscences and Veterinary Medicine, University of Camerino, 62024 Camerino, Italy;
| | - Arianna Miglio
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (M.T.A.); (M.L.M.); (A.L.M.); (L.A.); (E.C.)
- Correspondence:
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Avenick D, Kidd L, Istvan S, Dong F, Richter K, Edwards N, Hisada Y, Posma JJN, Massih CA, Mackman N. Effects of storage and leukocyte reduction on the concentration and procoagulant activity of extracellular vesicles in canine packed red cells. J Vet Emerg Crit Care (San Antonio) 2021; 31:221-230. [PMID: 33751799 DOI: 10.1111/vec.13050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 06/01/2019] [Accepted: 06/24/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To characterize the size and procoagulant activity of extracellular vesicles (EV) that accumulate in canine packed red blood cells (pRBCs) over time and the effect of leukocyte reduction on these characteristics. DESIGN Prospective cohort study. SETTING Private small animal specialty referral hospital and university research laboratories. ANIMALS Ten healthy blood donor dogs. INTERVENTIONS Five pRBCs units were obtained according to standard protocols, and 5 were leukocyte-reduced prior to processing. Platelet-free supernatant from the pRBC units was collected on days 0, 10, 20, 32, and 42. MEASUREMENTS AND MAIN RESULTS Nanoparticle tracking analysis was performed to determine the size and concentration of EVs. Thrombin generation associated with phosphatidylserine-positive EVs was determined using a capture assay. Factor Xa generation associated with phosphatidylserine-positive EVs and tissue factor-positive EVs was measured in a subset of EVs isolated by centrifugation of the supernatant at 20,000 × g. R package nparLD and the Mann-Whitney U-test were used to determine the effect of duration of storage and the effect of leukocyte reduction, respectively. Small (mean < 125 nm) procoagulant EVs accumulated over time, with significant increases occurring on or after day 20 in both non-leukocyte reduced and leukocyte-reduced units. The procoagulant activity of the EVs was due to phosphatidylserine, not tissue factor. Increases in EV concentration and procoagulant activity occurred earlier in non-leukocyte reduced units. Extracellular vesicle accumulation and procoagulant activity were not decreased at any individual time point by leukocyte reduction. CONCLUSIONS Further studies characterizing and determining the clinical relevance of small procoagulant EVs in pRBCs are warranted.
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Affiliation(s)
| | - Linda Kidd
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, California
| | | | - Fanglong Dong
- Graduate College of Biomedical Sciences, Western University of Health Sciences, Pomona, California
| | - Keith Richter
- Veterinary Specialty Hospital, San Diego, California
| | | | - Yohei Hisada
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jens J N Posma
- Departments of Internal Medicine and Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Cherein Abdel Massih
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, California
| | - Nigel Mackman
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Stefani A, Capello K, Carminato A, Wurzburger W, Furlanello T, Bertazzo V, Marsilio E, Albertin E, La Pietra G, Bozzato E, Mutinelli F, Vascellari M. Effects of leukoreduction on storage lesions in whole blood and blood components of dogs. J Vet Intern Med 2021; 35:936-945. [PMID: 33591603 PMCID: PMC7995433 DOI: 10.1111/jvim.16039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 01/11/2021] [Accepted: 01/15/2021] [Indexed: 12/15/2022] Open
Abstract
Background Leukoreduction is a routine procedure in human transfusion medicine but is uncommon in veterinary. Objectives To evaluate the effect of leukoreduction on the quality of canine whole blood (WB) and blood products during storage. Animals Ten canine blood donors. Methods This is a case series study. An amount of 450 mL of blood was collected from each dog. Five WB and 5 packed red blood cells (pRBC) bags were divided into 2 units each: leukoreduced (LR) and non‐leukoreduced (nLR). RBC count, erythrocytes' mean osmotic fragility (MOF), 2,3‐diphosphoglycerate (2,3‐DPG), adenosine triphosphate (ATP), percentage of hemolysis, potassium (K), lactate, glucose, and cytokines were measured weekly from day of donation (T0) to day 35 (T35); pH, coagulation times, and clotting factors were evaluated at T0 and T35 from WB and in fresh frozen plasma after 1 year of storage. Results Leukoreduction showed positive effects on lactate (T35: LR WB 14.42 mmol/L SD 2.71, nLR WB 22.42 mmol/L SD 1.86, LR pRBC 20.88 mmol/L SD 2.65, nLR pRBC 36.81 mmol/L SD 2.34; P < .0001), pH (T35: LR WB 6.88 SD 0.16, nLR WB 6.69 SD 0.20, P = .02; LR pRBC 6.57 SD 0.23, nLR pRBC 6.22 SD 0.11; P < .001), and K (LR pRBC 4.08 mmol/L SD 0.88, nLR pRBC 5.48 mmol/L SD 0.90; P < .001). Increasing values of IL8 were observed in nLR units during storage (T0: 4167 ± 11 888 pg/mL; T35: 6367 ± 11 612 pg/mL). Conclusion and Clinical Importance LR blood units are recommended to critically ill dogs with marked inflammatory conditions.
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Affiliation(s)
- Annalisa Stefani
- SCS3 - Special Diagnostics, Histopathology and Parasitology, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padua, Italy
| | - Katia Capello
- SCS3 - Special Diagnostics, Histopathology and Parasitology, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padua, Italy
| | - Antonio Carminato
- Internal Medicine Section, Veterinary Medical Center "della Riviera", Camponogara, Venice, Italy
| | - Wendy Wurzburger
- SCS3 - Special Diagnostics, Histopathology and Parasitology, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padua, Italy
| | - Tommaso Furlanello
- Laboratory of Veterinary Diagnostics, San Marco Veterinary Private Clinic, Veggiano, Padua, Italy
| | - Valentina Bertazzo
- SCS3 - Special Diagnostics, Histopathology and Parasitology, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padua, Italy
| | - Elisabetta Marsilio
- SCS3 - Special Diagnostics, Histopathology and Parasitology, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padua, Italy
| | - Elena Albertin
- SCS3 - Special Diagnostics, Histopathology and Parasitology, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padua, Italy
| | - Giacomo La Pietra
- SCS3 - Special Diagnostics, Histopathology and Parasitology, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padua, Italy
| | - Elisa Bozzato
- SCS3 - Special Diagnostics, Histopathology and Parasitology, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padua, Italy
| | - Franco Mutinelli
- SCS3 - Special Diagnostics, Histopathology and Parasitology, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padua, Italy
| | - Marta Vascellari
- SCS3 - Special Diagnostics, Histopathology and Parasitology, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padua, Italy
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10
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The Effects of Pre-Storage Leukoreduction on the Conservation of Bovine Whole Blood in Plastic Bags. BIOLOGY 2020; 9:biology9120444. [PMID: 33291543 PMCID: PMC7761855 DOI: 10.3390/biology9120444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/30/2020] [Accepted: 10/31/2020] [Indexed: 11/17/2022]
Abstract
Simple Summary Blood transfusion is a life-saving veterinary therapeutic procedure. While fractionated blood components are used in humans, whole blood is most commonly used in animals, especially for farm animals. Whole blood contains white blood cells that can cause a transfusion reaction in animals. Here, we proposed that using a blood bag with leukocyte filtration is sufficient for blood conservation under field conditions and thus can be an option for transfusion medicine in the case of farm animals. The filtered bag was efficient in removing white cells from cattle whole blood and could be used under field conditions. Blood stored after white blood cells were removed showed less acidic load. Further experimental studies are required to prove that blood without white cells results in a decrease in transfusion reactions in cattle. Abstract Leukoreduction (LR) is a technique that consists of reducing the number of leukocytes in whole blood or blood components that can contribute to decreasing storage lesions and the occurrence of post-transfusion complications. We propose that using a blood bag with pre-storage leukocyte filtration is sufficient for blood conservation under field conditions. Ten healthy Nelore cows were used. Whole blood was sampled from each animal and stored at 2 to 6 °C in CPD/SAG-M (citrate phosphate dextrose bag with a saline, adenine, glucose, mannitol satellite bag) triple bags (Control) and in CPD/SAG-M quadruple bags with a leukocyte filter (Filter). At baseline and after 7, 14, 21, 28, 35, and 42 days (D0, D7, D14, D21, D28, D35, and D42, respectively), complete hematological, blood gas, and biochemical evaluations were determined. The filtered bag removed 99.3% of white blood cells from cattle blood, and the entire filtration process was performed in the field. There was a reduction in the number of red blood cells (RBCs) in both groups from D14 onward, with a decrease of 19.7% and 17.1% at D42 for the Control and Filter bags, respectively. The hemoglobin (Hb) concentration had variation in both groups. Potassium, pO2, pCO2, and sO2 increased, and sodium, bicarbonate, and pH decreased during storage. The filtered bag was efficient in removing white cells from cattle whole blood and could be used under field conditions. Blood stored after LR showed differences (p < 0.05) in blood gas analysis towards a better quality of stored blood (e.g., higher pH, lower pCO2, higher sO2). Further experimental studies are required to prove that blood without white cells results in a decrease in transfusion reactions in cattle.
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McQuinn ER, Smith SA, Viall AK, Wang C, LeVine DN. Neutrophil extracellular traps in stored canine red blood cell units. J Vet Intern Med 2020; 34:1894-1902. [PMID: 32881076 PMCID: PMC7517510 DOI: 10.1111/jvim.15876] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 07/18/2020] [Accepted: 08/05/2020] [Indexed: 12/21/2022] Open
Abstract
Background Neutrophil extracellular traps (NETs), webs of DNA and citrullinated histones extruded from activated neutrophils cause transfusion‐related acute lung injury. Supernatants of stored red blood cell (RBC) units might promote NETosis in neutrophils from the units or from transfusion recipients. Hypotheses (1) NETs form during storage of canine RBC, (2) leukoreduction (LR) before storage of RBC reduces NETosis, and (3) supernatant from stored, nonleukoreduced (NLR) RBC units induces NETosis in healthy canine neutrophils modeling transfusion recipients. Animals Six healthy purpose‐bred research dogs were utilized for blood donation. Methods Prospective controlled study. RBC units were collected from each dog, aseptically divided into 2 equal subunits, 1 of which was leukoreduced, and stored for 42 days. Stored units were sampled biweekly for quantification of NET markers citrullinated histone H3 (Western blot) and cell‐free DNA (cfDNA) (DNA dye binding). Unit supernatants were applied ex vivo to canine neutrophils and extracellular DNA release representing NETosis was assessed. Results Markers of NETs increased during RBC storage (cfDNA P < .0001 and citrullinated H3 P = .0002) and were higher in NLR than LR units (day 42 LR cfDNA 0.34 ± 0.82 ng/mL vs day 42 NLR 1361.07 ± 741.00 ng/mL, P < .0001; day 42 LR citrullinated H3 0.19 ± 0.13 AU vs NLR 0.57 ± 0.34 AU, P = .007). Isolated neutrophils did not form NETs when exposed to stored canine RBC supernatant. Conclusions and Clinical Importance NETosis occurs in stored canine NLR RBC units, and is attenuated by LR before storage. NETs might be mediators of transfusion reactions.
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Affiliation(s)
- Erin R McQuinn
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, Iowa, USA
| | - Stephanie A Smith
- Department of Biochemistry, College of Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Austin K Viall
- Department of Veterinary Pathology, Iowa State University, Ames, Iowa, USA
| | - Chong Wang
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, Iowa, USA
| | - Dana N LeVine
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, Iowa, USA
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Fahradyan V, Annunziata MJ, Said S, Rao M, Shah H, Ordenana C, Papay FA, Rampazzo A, Bassiri Gharb B. Leukoreduction in ex vivo perfusion circuits: comparison of leukocyte depletion efficiency with leukocyte filters. Perfusion 2020; 35:853-860. [PMID: 32404024 DOI: 10.1177/0267659120917872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Leukodepletion of whole blood-based perfusates remains a challenge in experimental models of ex vivo perfusion. This study investigated the leukoreduction efficacy of the commonly used LeukoGuard LG Arterial and BC2 Cardioplegia filters. METHODS Eleven liters of washed porcine blood was used to evaluate the filtration efficiency of LG (n = 6) and BC2 (n = 5) filters. Filter efficacy was tested by passing 1 L of washed blood through each filter. Complete blood count was performed to detect a reduction of white blood cells, red blood cells, and hemoglobin concentration. RESULTS The BC2 Cardioplegia filter showed a significant reduction in white blood cell count (13.16 ± 4.2 × 103 cells/μL pre-filtration, 0.62 ± 0.61 cells/μL post-filtration, p = 0.005), red blood cell count (9.18 ± 0.16 × 106 cells/μL pre-filtration, 9.02 ± 0.16 × 106 cells/μL post-filtration, p = 0.012) and hemoglobin concentration (15.89 ± 0.66 g/dL pre-filtration, 15.67 ± 0.83 g/dL post-filtration, p = 0.017). Platelet reduction in the LG filter group was statistically significant (13.23 ± 13.98 × 103 cells/μL pre-filtration, 7.15 ± 3.31 × 103 cells/μL post-filtration, p = 0.029), but no difference was seen in the BC2 group. There was no significant difference in white blood cell count in the LG filter group (10.12 ± 3.0 × 103 cells/μL pre-filtration, 10.32 ± 2.44 × 103 cells/μL post-filtration, p = 0.861). CONCLUSION Our results suggest that the LG filter should not be used in ex vivo perfusion circuits for the purpose of leukodepletion. The BC2 filter can be used in EVP circuits with flow rates of less than 350 mL/min. Alternatively, perfusate may be leukodepleted before perfusion.
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Affiliation(s)
- Vahe Fahradyan
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | | | - Sayf Said
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Maya Rao
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Hirsh Shah
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Carlos Ordenana
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Frank A Papay
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Antonio Rampazzo
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA
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Lucchese L, Ravagnan S, Da Rold G, Toniolo F, Wurzburger W, Mion M, Carminato A, Fournier PE, Capelli G, Natale A, Vascellari M. Survival of Rickettsia conorii in artificially contaminated whole and leukoreduced canine blood units during the storage period. Parasit Vectors 2020; 13:118. [PMID: 32312308 PMCID: PMC7171768 DOI: 10.1186/s13071-020-3991-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 02/24/2020] [Indexed: 12/05/2022] Open
Abstract
Background The ability of tick-borne agents to survive in stored blood bags is a key factor for their transmissibility by blood transfusion. The aim of this study was to evaluate the survival and potential infectivity of Rickettsia conorii (RC) in artificially contaminated canine whole blood (WB) and in leukoreduced whole blood (LR-WB) during the storage period. Methods RC was cultured on L929 cells. We used a one-week 25-cm2 flask with 70–80% of L929 infected cells to prepare the bacterial inoculum by pelleting cells and suspending the pellet in the donors’ serum. We infected five 100 ml WB units with RC within 2 h from the collection and maintained it at room temperature for 4 h prior to refrigeration. We filtered 50 ml of each WB bag to obtain leukoreduced WB (LR-WB) at day 1 post-infection (dpi). We checked WB and LR-WB bags at 1, 4, 7, 14, 21, 28, 35 dpi for RC presence and viability through real-time PCR (rPCR) for DNA and mRNA, respectively, and by isolation. Identification of isolates was confirmed by indirect immunofluorescence and rPCRs. Results RC survived for the entire storage period in both whole and leukoreduced blood. All bags contained viable bacteria until 7 dpi; RC viability generally decreased over time, particularly in LR-WB bags where the isolation time was longer than in WB. Viable bacteria were still isolated at 35 dpi in 3 WB and 3 LR-WB. Conclusions Leukoreduction reduced but did not eliminate RC in infected units. The survival and infectivity of RC in canine blood during the storage period may represent a threat for recipients.![]()
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Affiliation(s)
- Laura Lucchese
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, PD, Italy
| | - Silvia Ravagnan
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, PD, Italy
| | - Graziana Da Rold
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, PD, Italy
| | - Federica Toniolo
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, PD, Italy
| | - Wendy Wurzburger
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, PD, Italy
| | - Monica Mion
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, PD, Italy
| | - Antonio Carminato
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, PD, Italy
| | | | - Gioia Capelli
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, PD, Italy.
| | - Alda Natale
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, PD, Italy
| | - Marta Vascellari
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, PD, Italy
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Hinson WD, Rogovskyy AS, Lawhon SD, Thieman Mankin KM. Influence of a cell salvage washing system and leukocyte reduction filtration on bacterial contamination of canine whole blood ex vivo. Vet Surg 2020; 49:989-996. [PMID: 32166777 DOI: 10.1111/vsu.13410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 12/12/2019] [Accepted: 02/24/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To determine the ability of cell salvage washing and leukoreduction filtration to remove bacterial contamination from canine whole blood. STUDY DESIGN Ex vivo nested cohort study. SAMPLE POPULATION Commercially purchased fresh canine whole blood (n = 33 units). METHODS Commercially obtained canine whole blood was inoculated with known concentrations of one of three species of bacteria, Escherichia coli (ATCC 25922), Staphylococcus pseudintermedius (quality control strain; Texas A&M University), or Pseudomonas aeruginosa (ATCC 27853). Negative controls were inoculated with sterile saline. The inoculated blood was processed through a cell salvage system and filtered through a series of two leukocyte reduction filters. Samples were aseptically collected at five points during processing (inoculum, prewash, postwash, post-first filtration, and post-second filtration) for bacterial enumeration. RESULTS Bacterial concentrations were reduced by 85.2%, 91.5%, and 93.9% for E coli, S pseudintermedius, and P aeruginosa, respectively, after washing (P < .0001), and bacterial concentrations were reduced by 99.9%, 100%, and 100%, respectively, after the first filtration (P < .0001). After the second filtration, none of the three species of bacteria could be isolated (100% reduction). No bacterial growth was obtained from negative controls throughout the study. The type of bacteria (P = .29) did not allow prediction of bacterial reduction. CONCLUSION Cell salvage washing combined with leukoreduction filtration eliminated bacterial contamination of whole dog blood (P < .0001). CLINICAL SIGNIFICANCE Cell salvage washing and leukoreduction filtration could be applied to intraoperative autotransfusion in clinical animals, especially those treated for trauma or hemorrhage with concurrent bacterial contamination.
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Affiliation(s)
- Whitney D Hinson
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M College of Veterinary Medicine, College Station, Texas
| | - Artem S Rogovskyy
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M College of Veterinary Medicine, College Station, Texas
| | - Sara D Lawhon
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M College of Veterinary Medicine, College Station, Texas
| | - Kelley M Thieman Mankin
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M College of Veterinary Medicine, College Station, Texas
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Foote ML, Brooks MB, Archer TM, Wills RW, Mackin AJ, Thomason JM. Coagulation factor activity in units of leukoreduced and nonleukoreduced canine fresh-frozen plasma. Am J Vet Res 2019; 80:846-851. [PMID: 31449444 DOI: 10.2460/ajvr.80.9.846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate coagulation factors in units of leukoreduced (LR) and nonleukoreduced (non-LR) canine fresh-frozen plasma (cFFP). ANIMALS 8 healthy research dogs. PROCEDURES In a crossover study, dogs were randomly assigned to 1 of 2 groups from which blood was collected and either did or did not undergo leukoreduction. After a recovery period of ≥ 28 days, the dogs were switched between protocols. After each collection, blood samples were centrifuged, and cFFP was stored frozen for later comparative analysis of coagulation factors, antithrombin, and protein C activities (reported as comparative percentages of the corresponding activities determined in a canine pooled plasma standard); prothrombin and activated partial thromboplastin times; and fibrinogen concentration. RESULTS There were no significant differences detected between results for LR cFFP, compared with those for non-LR cFFP. CONCLUSIONS AND CLINICAL RELEVANCE Although there was variation among residual activities of coagulation factors in LR and non-LR cFFP, the variations and differences were considered unlikely to impact the efficacy of LR cFFP transfused for coagulation factor replacement in dogs. However, owing to the small sample size and high variability of results in the present study, additional research with a larger sample size is required for definitive conclusions on the effects of leukoreduction on coagulation factors in cFFP and to develop treatment guidelines for LR cFFP use in dogs with congenital and acquired coagulopathies.
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Bosch Lozano L, Blois SL, Wood RD, Abrams-Ogg ACG, Bersenas AM, Bateman SW, Richardson DM. A pilot study evaluating the effects of prestorage leukoreduction on markers of inflammation in critically ill dogs receiving a blood transfusion. J Vet Emerg Crit Care (San Antonio) 2019; 29:385-390. [PMID: 31218809 DOI: 10.1111/vec.12857] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 06/22/2017] [Accepted: 07/01/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To compare markers of inflammation after transfusion of leukoreduced (LR) packed RBCs (pRBCs) versus non-LR pRBCs in dogs with critical illness requiring blood transfusion, and to report survival to discharge and rates of transfusion reactions in these dogs. DESIGN Prospective randomized blinded clinical study June 2014-September 2015. SETTING University veterinary teaching hospital. ANIMALS Twenty-three client-owned critically ill dogs, consecutively enrolled. INTERVENTIONS Dogs requiring a single pRBC transfusion were randomized into the LR or non-LR pRBC group. Exclusion criteria included: requirement for multiple blood products, history of previous blood transfusion, and administration of anti-inflammatory or immunosuppressive medication prior to enrollment. MEASUREMENTS Blood samples were obtained immediately prior to transfusion, then 2 and 24 hours following transfusion. Parameters measured at each time point included: PCV, WBC count, segmented and band neutrophil counts, fibrinogen, and plasma lactate and C-reactive protein concentrations. Acute patient physiologic and laboratory evaluation fast score was calculated on admission. RESULTS Eleven dogs were included in the LR group and 12 in the non-LR group; scores of illness severity were not significantly different between groups. Total WBC count was significantly higher in the non-LR versus LR group 24 hours following pRBC transfusion, but this difference was not evident 2 hours following transfusion. No other inflammatory parameters at any time point were significantly different between LR versus non-LR pRBC transfused dogs. Survival rates to discharge for LR and non-LR groups were 8/11 and 9/12, respectively. Acute transfusion reactions were identified in 1/11 and 2/12 dogs in the LR and non-LR group, respectively. All transfused blood was stored ≤12 days. CONCLUSIONS Most markers of inflammation did not significantly increase following transfusion of LR versus non-LR pRBCs stored ≤12 days in ill dogs. Further prospective, randomized trials are needed in clinically ill dogs to determine the benefit of prestorage leukoreduction.
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Affiliation(s)
- Luis Bosch Lozano
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Ontario, Canada
| | - Shauna L Blois
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Ontario, Canada
| | - R Darren Wood
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Ontario, Canada
| | - Anthony C G Abrams-Ogg
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Ontario, Canada
| | - Alexa M Bersenas
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Ontario, Canada
| | - Shane W Bateman
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Ontario, Canada
| | - Danielle M Richardson
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Ontario, Canada
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Ferreira RRF, Graça RMC, Cardoso IM, Gopegui RR, de Matos AJF. In vitro hemolysis of stored units of canine packed red blood cells. J Vet Emerg Crit Care (San Antonio) 2018; 28:512-517. [DOI: 10.1111/vec.12770] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 11/02/2016] [Accepted: 11/23/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Rui R. F. Ferreira
- Departments of Veterinary Clinics; Institute for Biomedical Sciences of Abel Salazar; University of Porto; Porto Portugal
| | | | | | - Rafael R. Gopegui
- Department of Animal Medicine and Surgery; Veterinary Faculty; Barcelona Autonomous University; Barcelona Spain
| | - Augusto J. F. de Matos
- Departments of Veterinary Clinics; Institute for Biomedical Sciences of Abel Salazar; University of Porto; Porto Portugal
- Multidisciplinary Unit for Biomedical Research; Porto Portugal
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Ciepluch B, Wilson-Robles H, Levine G, Smith R, Wright GA, Miller T, O'Brien MT, Thieman Mankin KM. Removal of hemangiosarcoma cells from canine blood with a cell salvage system and leukocyte reduction filter. Vet Surg 2017; 47:293-301. [DOI: 10.1111/vsu.12760] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 06/22/2017] [Accepted: 06/29/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Brittany Ciepluch
- Department of Small Animal Clinical Sciences; Texas A&M University; College Station Texas
| | - Heather Wilson-Robles
- Department of Small Animal Clinical Sciences; Texas A&M University; College Station Texas
| | - Gwendolyn Levine
- Department of Veterinary Pathobiology; Texas A&M University; College Station Texas
| | - Roger Smith
- Department of Veterinary Pathobiology; Texas A&M University; College Station Texas
| | - Gus A. Wright
- Department of Veterinary Pathobiology; Texas A&M University; College Station Texas
| | - Tasha Miller
- Department of Small Animal Clinical Sciences; Texas A&M University; College Station Texas
| | - Maureen T. O'Brien
- Department of Veterinary Pathobiology; Texas A&M University; College Station Texas
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Pourbaghi R, Zarrebini M, Semnani D, Pourazar A, Akbari N, Shamsfar R. Evaluation of polyacrylonitrile electrospun nano-fibrous mats as leukocyte removal filter media. J Biomed Mater Res B Appl Biomater 2017; 106:1759-1769. [DOI: 10.1002/jbm.b.33980] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 07/12/2017] [Accepted: 08/16/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Raha Pourbaghi
- Department of Textile Engineering; Isfahan University of Technology; Isfahan Iran
| | - Mohammad Zarrebini
- Department of Textile Engineering; Isfahan University of Technology; Isfahan Iran
| | - Dariush Semnani
- Department of Textile Engineering; Isfahan University of Technology; Isfahan Iran
| | - Abbasali Pourazar
- Department of Immunology; School of Medicine, Isfahan University of Medical Sciences; Isfahan Iran
| | - Nahid Akbari
- Isfahan Blood Transfusion Organization; Isfahan Iran
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Maglaras CH, Koenig A, Bedard DL, Brainard BM. Retrospective evaluation of the effect of red blood cell product age on occurrence of acute transfusion-related complications in dogs: 210 cases (2010-2012). J Vet Emerg Crit Care (San Antonio) 2016; 27:108-120. [PMID: 27669368 DOI: 10.1111/vec.12530] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 02/08/2015] [Accepted: 03/17/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To determine whether red blood cell (RBC) product age influences the occurrence of acute transfusion-related complications and mortality in dogs. The hypothesis was that acute transfusion-related complications and mortality would increase with age of product. DESIGN Retrospective study (2010-2012). SETTING University teaching hospital. ANIMALS Two hundred and ten clinical canine patients. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Medical records were reviewed for dogs receiving RBC-containing products. Patient signalment; reason for transfusion; product type, dose, age, and source; pretransfusion compatibility; rate, route, and method of administration; administration of multiple transfusions; underlying disease; occurrence of transfusion-related complications (eg, fever, hemolysis, gastrointestinal distress, cardiovascular, neurologic, and respiratory complications); various hematologic parameters; and survival were recorded. Data were analyzed for association between potential risk factors and occurrence of transfusion-related complications as well as between transfusion-related complications and survival. Of 333 transfusion events in 210 patients, 84 transfusion-related complications occurred. Fever was most common (41/333), followed by hemolysis (21/333). For every additional day of product age, the odds of hemolysis increased significantly (odds ratio, 1.11; 95% confidence interval, 1.06-1.16; P < 0.0001). Transfusion-related complications when considered as a whole were associated with higher dose of product, longer duration of administration per transfusion event, and immune-mediated disease, but not with source of product or general category of anemia. Administration rate was significantly slower in patients with febrile transfusion-related complications (P < 0.0001). Product age was not associated with increased mortality. CONCLUSIONS Age of stored RBC products is associated with increased risk of transfusion-related hemolysis, but not with fever. Prospective clinical studies evaluating the influence of storage duration on development of in vitro versus in vivo hemolysis are warranted.
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Affiliation(s)
- Christina H Maglaras
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602
| | - Amie Koenig
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602
| | - Deanna L Bedard
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602
| | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602
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Cummings KA, Abelson AL, Rozanski EA, Sharp CR. The effect of storage on ammonia, cytokine, and chemokine concentrations in feline whole blood. J Vet Emerg Crit Care (San Antonio) 2016; 26:639-45. [DOI: 10.1111/vec.12510] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 12/12/2014] [Accepted: 01/22/2015] [Indexed: 02/04/2023]
Affiliation(s)
- Katherine A. Cummings
- Department of Clinical Sciences, Cummings School of Veterinary Medicine; Tufts University; North Grafton MA 01536
| | - Amanda L. Abelson
- Department of Clinical Sciences, Cummings School of Veterinary Medicine; Tufts University; North Grafton MA 01536
| | - Elizabeth A. Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine; Tufts University; North Grafton MA 01536
| | - Claire R. Sharp
- Department of Clinical Sciences, Cummings School of Veterinary Medicine; Tufts University; North Grafton MA 01536
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Purcell SL, Claus M, Hosgood G, Smart L. Effect of leukoreduction on concentrations of interleukin-8, interleukin-1β, and tumor necrosis factor-α in canine packed red blood cells during storage. Am J Vet Res 2016; 76:969-74. [PMID: 26512542 DOI: 10.2460/ajvr.76.11.969] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To measure changes in interleukin-8 (IL-8), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) concentrations in stored canine packed RBCs (PRBCs) over time and assess the effect of leukoreduction on these cytokine concentrations. ANIMALS 12 anesthetized healthy Greyhounds. PROCEDURES 1 unit of whole blood from each dog was processed into PRBCs. Half of each PRBCs unit was passed through a leukoreduction filter to produce a leukoreduced unit, and the remaining blood was kept as a nonleukoreduced unit. All units had a CBC performed on day 0 (day of collection) and were stored at 2° to 6°C. Samples were collected from leukoreduced and nonleukoreduced units on days 0, 10, 20, 30, and 37 and centrifuged; the supernatant was stored at -80°C until analysis. Canine TNF-α and IL-8 concentrations were assessed with a multiplexed genomic and proteomic biomarker analyzer, and canine IL-1β concentration was measured by ELISA. RESULTS Leukocyte counts were decreased by ≥ 99.9% in all leukoreduced units. Median TNF-α and IL-1β concentrations were not significantly different between leukoreduced and nonleukoreduced units and did not change significantly during storage; median IL-8 concentration was significantly higher in nonleukoreduced versus leukoreduced units on all days, and was greater at all time points after ≥ 10 days of storage than on day 0. Median IL-8 concentration in leukoreduced units did not increase during storage. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that leukoreduction was effective for the removal of leukocytes from canine PRBCs and prevented significant increases in IL-8 concentration during storage. Further studies are needed to evaluate whether leukoreduction reduces cytokine-associated complications of transfusion.
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Hofbauer N, Windberger U, Schwendenwein I, Tichy A, Eberspächer E. Evaluation of canine red blood cell quality after processing with an automated cell salvage device. J Vet Emerg Crit Care (San Antonio) 2016; 26:373-83. [DOI: 10.1111/vec.12472] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 09/29/2014] [Accepted: 10/16/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Nina Hofbauer
- Department of Anesthesiology and Perioperative Intensive Care; University of Veterinary Medicine; Vienna Austria
| | - Ursula Windberger
- Decentralized Biomedical Facilities of the Medical University of Vienna; Vienna Austria
| | - Ilse Schwendenwein
- Department of Pathobiology, Central Laboratory; University of Veterinary Medicine; Vienna Austria
| | - Alexander Tichy
- Department of Biomedical Sciences; University of Veterinary Medicine; Vienna Austria
| | - Eva Eberspächer
- Department of Anesthesiology and Perioperative Intensive Care; University of Veterinary Medicine; Vienna Austria
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Cortés-Puch I, Remy KE, Solomon SB, Sun J, Wang D, Al-Hamad M, Kelly SM, Sinchar D, Bellavia L, Kanias T, Popovsky MA, Kim-Shapiro DB, Klein HG, Natanson C. In a canine pneumonia model of exchange transfusion, altering the age but not the volume of older red blood cells markedly alters outcome. Transfusion 2015; 55:2564-75. [PMID: 26469998 PMCID: PMC4644122 DOI: 10.1111/trf.13275] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 05/29/2015] [Accepted: 06/30/2015] [Indexed: 01/28/2023]
Abstract
BACKGROUND Massive exchange transfusion of 42-day-old red blood cells (RBCs) in a canine model of Staphylococcus aureus pneumonia resulted in in vivo hemolysis with increases in cell-free hemoglobin (CFH), transferrin-bound iron (TBI), non-transferrin-bound iron (NTBI), and mortality. We have previously shown that washing 42-day-old RBCs before transfusion significantly decreased NTBI levels and mortality, but washing 7-day-old RBCs increased mortality and CFH levels. We now report the results of altering volume, washing, and age of RBCs. STUDY DESIGN AND METHODS Two-year-old purpose-bred infected beagles were transfused with increasing volumes (5-10, 20-40, or 60-80 mL/kg) of either 42- or 7-day-old RBCs (n = 36) or 80 mL/kg of either unwashed or washed RBCs with increasing storage age (14, 21, 28, or 35 days; n = 40). RESULTS All volumes transfused (5-80 mL/kg) of 42-day-old RBCs resulted in alike (i.e., not significantly different) increases in TBI during transfusion as well as in CFH, lung injury, and mortality rates after transfusion. Transfusion of 80 mL/kg RBCs stored for 14, 21, 28, and 35 days resulted in increased CFH and NTBI in between levels found at 7 and 42 days of storage. However, washing RBCs of intermediate ages (14-35 days) does not alter NTBI and CFH levels or mortality rates. CONCLUSIONS Preclinical data suggest that any volume of 42-day-old blood potentially increases risks during established infection. In contrast, even massive volumes of 7-day-old blood result in minimal CFH and NTBI levels and risks. In contrast to the extremes of storage, washing blood stored for intermediate ages does not alter risks of transfusion or NTBI and CFH clearance.
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Affiliation(s)
- Irene Cortés-Puch
- Critical Care Medicine Department, Clinical Center, NIH, Bethesda, Maryland, USA
| | - Kenneth E. Remy
- Critical Care Medicine Department, Clinical Center, NIH, Bethesda, Maryland, USA
| | - Steven B. Solomon
- Critical Care Medicine Department, Clinical Center, NIH, Bethesda, Maryland, USA
| | - Junfeng Sun
- Critical Care Medicine Department, Clinical Center, NIH, Bethesda, Maryland, USA
| | - Dong Wang
- Critical Care Medicine Department, Clinical Center, NIH, Bethesda, Maryland, USA
| | - Mariam Al-Hamad
- Critical Care Medicine Department, Clinical Center, NIH, Bethesda, Maryland, USA
| | - Seth M. Kelly
- Critical Care Medicine Department, Clinical Center, NIH, Bethesda, Maryland, USA
| | - Derek Sinchar
- Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, 15213
| | - Landon Bellavia
- Department of Physics and the Translational Science Center, Wake Forest University, Winston-Salem, NC 27109
| | - Tamir Kanias
- Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, 15213
| | | | - Daniel B. Kim-Shapiro
- Department of Physics and the Translational Science Center, Wake Forest University, Winston-Salem, NC 27109
| | - Harvey G. Klein
- Department of Transfusion Medicine, Clinical Center, NIH, Bethesda, Maryland, USA
| | - Charles Natanson
- Critical Care Medicine Department, Clinical Center, NIH, Bethesda, Maryland, USA
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Fontes JA, Banerjee U, Iazbik MC, Marín LM, Couto CG, Palmer AF. Effect of ascorbic acid on storage of Greyhound erythrocytes. Am J Vet Res 2015; 76:789-800. [PMID: 26309107 DOI: 10.2460/ajvr.76.9.789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess changes in biochemical and biophysical properties of canine RBCs during cold (1° to 6°C) storage in a licensed RBC additive solution (the RBC preservation solution designated AS-1) supplemented with ascorbic acid. SAMPLE Blood samples from 7 neutered male Greyhounds; all dogs had negative results when tested for dog erythrocyte antigen 1.1. PROCEDURES Blood was collected into citrate-phosphate-dextrose and stored in AS-1. Stored RBCs were supplemented with 7.1mM ascorbic acid or with saline (0.9% NaCl) solution (control samples). Several biochemical and biophysical properties of RBCs were measured, including percentage hemolysis, oxygen-hemoglobin equilibrium, and the kinetic rate constants for O2 dissociation, carbon monoxide association, and nitric oxide dioxygenation. RESULTS Greyhound RBCs stored in AS-1 supplemented with ascorbic acid did not have significantly decreased hemolysis, compared with results for the control samples, during the storage period. CONCLUSIONS AND CLINICAL RELEVANCE In this study, ascorbic acid did not reduce hemolysis during storage. Several changes in stored canine RBCs were identified as part of the hypothermic storage lesion.
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26
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Haematologic effects of leukoreduction on canine whole blood post-filtration and post-storage. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/s00580-015-2155-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Obrador R, Musulin S, Hansen B. Red blood cell storage lesion. J Vet Emerg Crit Care (San Antonio) 2014; 25:187-99. [PMID: 25428860 DOI: 10.1111/vec.12252] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 10/01/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To summarize current understanding of the mechanisms responsible for changes occurring during red blood cell (RBC) storage, collectively known as the storage lesion, and to review the biological and clinical consequences of increasing storage time of RBCs. DATA SOURCES Human and veterinary clinical studies, experimental animal model studies, and reviews of the RBC storage lesion with no date restrictions. HUMAN DATA SYNTHESIS Experimental studies have characterized the evolution of human RBC and supernatant changes that occur during storage and form the basis for concern about the potential for harm from long-term storage of RBCs. Although 4 randomized controlled trials of varying sizes failed to find an association between RBC storage time and negative clinical outcomes, a recent meta-analysis and numerous observational clinical studies have demonstrated that transfusion of old versus fresh stored RBCs is associated with an increased risk of morbidity and mortality, particularly among trauma victims and cardiac surgery patients. Potential clinical consequences of RBC transfusion following development of the storage lesion include risk of organ dysfunction, organ failure, infections, and death. VETERINARY DATA SYNTHESIS Experimental animal models have contributed to the evidence supporting adverse consequences of the RBC storage lesion. Studies on relevant RBC storage issues such as the effect of different preservative solutions and leukoreduction have been completed. Transfusion with RBCs stored for 42 days increases mortality in dogs with experimental sepsis. CONCLUSION Storage of RBCs induces progressive biochemical, biomechanical, and immunologic changes that affect red cell viability, deformability, oxygen carrying capacity, microcirculatory flow, and recipient response. Most reports in the human and veterinary literature support the concept that there are deleterious effects of the RBC storage lesion, but additional studies with improved experimental design are needed to identify compelling reasons to modify current blood banking and transfusion practices.
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Affiliation(s)
- Rafael Obrador
- From the Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607
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Lacerda LA, Hlavac NRC, Terra SR, Back FP, Jane Wardrop K, González FHD. Effects of four additive solutions on canine leukoreduced red cell concentrate quality during storage. Vet Clin Pathol 2014; 43:362-70. [PMID: 25135622 DOI: 10.1111/vcp.12163] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Additive solutions (AS) and prestorage leukoreduction (LR) are important tools used to maintain erythrocyte viability during storage and avoid transfusion reactions in recipients, respectively. OBJECTIVES The purpose of the study was to determine the efficacy of a WBC filter (Immugard IIIRC) and compare the effect of 4 AS (phosphate-adenine-glucose-guanosine-gluconate-mannitol [PAGGGM], saline-adenine-glucose-mannitol [SAGM], Adsol, Optisol) on the in vitro quality of canine leukoreduced packed RBC units (pRBC) stored for 41 days. METHODS Five hundred milliliters of blood were collected from 8 healthy dogs each into 70 mL of citrate-phosphate-dextrose (CPD) solution, and were leukoreduced by a polyurethane filter. pRBC of each dog were divided equally into 4 bags containing a different AS. Bags were stored for 41 days at 4°C and evaluated every 10 days. Variables analyzed included pH, PCV, and% hemolysis, and lactate, glucose, potassium, sodium, ATP, and 2,3-diphosphoglycerate (2,3-DPG) concentrations. RESULTS The LR resulted in residual WBC counts comparable to human standards. During storage, pH, and glucose, 2,3-DPG, and ATP concentrations decreased, and hemolysis, and lactate, sodium, and potassium concentrations increased (P < .05). Significant differences between AS were seen in the glucose and sodium concentrations, due to the composition of AS. Also, the pH maintained by PAGGGM at day 21 was significantly higher than that seen with SAGM or Adsol. CONCLUSIONS All AS used gave satisfactory results during the first 21 days of storage based on the degree of hemolysis, and on ATP and 2,3-DPG concentrations. When compared with day 1 values, significant changes were seen in these variables by day 31 with all AS.
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Affiliation(s)
- Luciana A Lacerda
- Department of Veterinary Clinical Pathology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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29
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Corsi R, McMichael MA, Smith SA, O'Brien M, Herring J, Ngwenyama TR, Galligan A, Beloshapka AN, Deng P, Swanson KS. Cytokine concentration in stored canine erythrocyte concentrates. J Vet Emerg Crit Care (San Antonio) 2014; 24:259-63. [PMID: 24697952 DOI: 10.1111/vec.12160] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Accepted: 12/29/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the effect of leukoreduction (LR) as compared to standard nonleukoreduced (NLR) units on cytokine concentrations in canine erythrocyte concentrates during regular storage time. DESIGN Randomized, experimental study. SETTING University teaching hospital. ANIMALS Ten random-source research dogs. INTERVENTIONS One unit of whole blood was collected from each dog and randomized to standard processing (NLR, n = 5) or prestorage LR (n = 5). All units were stored at 4°C. Samples were aseptically collected from each unit weekly for 5 weeks. On day 35, 1 mL of blood was collected from each unit and submitted for aerobic culture. MEASUREMENT AND MAIN RESULTS An ELISA assay was used to analyze the concentrations of IL-1β, IL-8, TNF-α, and IL-10. There were no significant effects of either group or storage time for IL-1β, IL-10, or TNF-α. IL-8 concentration was significantly increased over the storage period in NLR units, and was significantly higher compared to LR units on days 28 and 35. Aerobic culture was negative on all units. CONCLUSIONS This study demonstrated a marked, storage time-dependent accumulation of IL-8 in canine erythrocyte concentrates. Prestorage LR attenuated the accumulation of IL-8. This chemokine may contribute to the proinflammatory effects of transfusion of stored erythrocyte concentrates.
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Affiliation(s)
- Raffaella Corsi
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Illinois at Urbana-Cham-paign, Urbana, IL, 61802
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Kisielewicz C, Self IA. Canine and feline blood transfusions: controversies and recent advances in administration practices. Vet Anaesth Analg 2014; 41:233-42. [PMID: 24576208 DOI: 10.1111/vaa.12135] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 11/15/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To discuss and review blood transfusion practices in dogs and cats including collection and storage of blood and administration of products. To report new developments, controversial practices, less conventional blood product administration techniques and where applicable, describe the relevance to anaesthetists and anaesthesia. DATABASES USED PubMed and Google Scholar using dog, cat, blood transfusion, packed red blood cells and whole blood as keywords. CONCLUSIONS Blood transfusions improve oxygen carrying capacity and the clinical signs of anaemia. However there are numerous potential risks and complications possible with transfusions, which may outweigh their benefits. Storage of blood products has improved considerably over time but whilst extended storage times may improve their availability, a phenomenon known as the storage lesion has been identified which affects erythrocyte viability and survival. Leukoreduction involves removing leukocytes and platelets thereby preventing their release of cytokines and bioactive compounds which also contribute to storage lesions and certain transfusion reactions. Newer transfusion techniques are being explored such as cell salvage in surgical patients and subsequent autologous transfusion. Xenotransfusions, using blood and blood products between different species, provide an alternative to conventional blood products.
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Affiliation(s)
- Caroline Kisielewicz
- Queen Mother Hospital for Animals, Royal Veterinary College, Hatfield, Hertfordshire, UK
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31
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Callan MB, Patel RT, Rux AH, Bandyopadhyay S, Sireci AN, O'Donnell PA, Ruane T, Sikora T, Marryott K, Sachais BS, Hod EA. Transfusion of 28-day-old leucoreduced or non-leucoreduced stored red blood cells induces an inflammatory response in healthy dogs. Vox Sang 2013; 105:319-27. [PMID: 23763639 DOI: 10.1111/vox.12058] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 04/16/2013] [Accepted: 04/26/2013] [Indexed: 01/24/2023]
Abstract
BACKGROUND AND OBJECTIVES Studies in mice suggest that rapid transfusions of red blood cells (RBCs), refrigerator stored for longer durations, induce a pro-inflammatory cytokine response. Studies in human neonates confirm these findings; however, to date, adult human studies have failed to replicate these findings. We used healthy research dogs to begin to examine the factors affecting the cytokine response to transfusion. MATERIALS AND METHODS In a prospective study, healthy dogs were randomized for two autologous packed RBC transfusions after 7 (i.e. 'fresh') and 28 (i.e. 'old') days of storage, or after 28 and 7 days of storage, with or without prestorage leucoreduction (LR). RESULTS No significant differences were observed between LR and non-LR transfusions for all circulating analytes measured following transfusion. A pro-inflammatory cytokine response, exemplified by monocyte chemoattractant protein-1, was observed 6 h after only old RBC transfusions, irrespective of infusion rate (P < 0·001). This response was accompanied by increased neutrophil counts (P < 0·001) and decreased platelet counts (P < 0·001). CONCLUSION In healthy dogs, old RBC transfusions induce inflammation, which is unaffected by infusion rate.
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Affiliation(s)
- M B Callan
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
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32
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Herring JM, Smith SA, McMichael MA, O'Brien M, Ngwenyama TR, Corsi R, Galligan A, Beloshapka AN, Deng P, Swanson KS. Microparticles in stored canine RBC concentrates. Vet Clin Pathol 2013; 42:163-9. [DOI: 10.1111/vcp.12034] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Jennifer M. Herring
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; University of Illinois; Urbana; IL; USA
| | - Stephanie A. Smith
- Department of Biochemistry; College of Medicine; University of Illinois; Urbana; IL; USA
| | - Maureen A. McMichael
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; University of Illinois; Urbana; IL; USA
| | - Mauria O'Brien
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; University of Illinois; Urbana; IL; USA
| | - Thandeka R. Ngwenyama
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; University of Illinois; Urbana; IL; USA
| | - Raffaella Corsi
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; University of Illinois; Urbana; IL; USA
| | - Alyssa Galligan
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; University of Illinois; Urbana; IL; USA
| | - Alison N. Beloshapka
- Department of Animal Sciences; College of Agricultural, Consumer & Environmental Sciences; University of Illinois; Urbana; IL; USA
| | - Ping Deng
- Department of Animal Sciences; College of Agricultural, Consumer & Environmental Sciences; University of Illinois; Urbana; IL; USA
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Mortality increases after massive exchange transfusion with older stored blood in canines with experimental pneumonia. Blood 2012; 121:1663-72. [PMID: 23255558 DOI: 10.1182/blood-2012-10-462945] [Citation(s) in RCA: 140] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Two-year-old purpose-bred beagles (n = 24) infected with Staphylococcus aureus pneumonia were randomized in a blinded fashion for exchange transfusion with either 7- or 42-day-old canine universal donor blood (80 mL/kg in 4 divided doses). Older blood increased mortality (P = .0005), the arterial alveolar oxygen gradient (24-48 hours after infection; P ≤ .01), systemic and pulmonary pressures during transfusion (4-16 hours) and pulmonary pressures for ~ 10 hours afterward (all P ≤ .02). Further, older blood caused more severe lung damage, evidenced by increased necrosis, hemorrhage, and thrombosis (P = .03) noted at the infection site postmortem. Plasma cell–free hemoglobin and nitric oxide (NO) consumption capability were elevated and haptoglobin levels were decreased with older blood during and for 32 hours after transfusion (all P ≤ .03). The low haptoglobin (r = 0.61; P = .003) and high NO consumption levels at 24 hours (r = −0.76; P < .0001) were associated with poor survival. Plasma nontransferrin-bound and labile iron were significantly elevated only during transfusion (both P = .03) and not associated with survival (P = NS). These data from canines indicate that older blood after transfusion has a propensity to hemolyze in vivo, releases vasoconstrictive cell-free hemoglobin over days, worsens pulmonary hypertension, gas exchange, and ischemic vascular damage in the infected lung, and thereby increases the risk of death from transfusion.
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Graf C, Raila J, Schweigert FJ, Kohn B. Effect of leukoreduction treatment on vascular endothelial growth factor concentration in stored canine blood transfusion products. Am J Vet Res 2012; 73:2001-6. [DOI: 10.2460/ajvr.73.12.2001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Defects in coagulation encountered in small animal critical care. Vet Clin North Am Small Anim Pract 2011; 41:783-803, vii. [PMID: 21757093 DOI: 10.1016/j.cvsm.2011.04.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Critically ill small animals are at risk for developing coagulation abnormalities. The processes of inflammation and coagulation are intertwined, and severe inflammation can lead to disturbances of coagulation. Severe coagulation dysfunction is associated with increased morbidity and mortality. Pathophysiology, diagnosis, and treatment of coagulation dysfunction are discussed. Defects in coagulation in small animal patients are complex and a consensus on diagnosis and treatment has yet to be reached.
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McDevitt RI, Ruaux CG, Baltzer WI. Influence of transfusion technique on survival of autologous red blood cells in the dog. J Vet Emerg Crit Care (San Antonio) 2011; 21:209-16. [PMID: 21631706 DOI: 10.1111/j.1476-4431.2011.00634.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the effect of 3 differing transfusion techniques on survival of autologous canine RBCs. DESIGN Prospective, blinded study. SETTING University Teaching Hospital. ANIMALS Nine healthy dogs. INTERVENTIONS Three distinct preparations of RBCs, each representing ~1% of red cell mass, were generated for each dog by biotinylation of RBCs at varying biotin densities. Labeled cells were transfused using 3 techniques (gravity, volumetric pump, syringe pump). Serial determinations of red cell survival were carried out by flow-cytometric analysis of RBCs collected at 7-day intervals for 49 days. In vitro analysis of the effect of transfusion methods on RBC integrity and osmotic fragility were carried out in 7/9 dogs. MEASUREMENTS AND MAIN RESULTS RBCs administered via volumetric and syringe pumps exhibited a marked decrease in short-term probability of survival compared with RBCs delivered by gravity flow. At 24 hours, only 4/8 and 1/7 dogs had surviving cell populations delivered by volumetric and syringe pump, respectively, compared with 8/8 dogs which had surviving cell populations delivered by gravity flow. Circulating half-life of cells surviving at 24 hours after delivery by volumetric pump was not significantly different to that delivered by gravity flow. No significant effect on in vitro RBC integrity or osmotic fragility was detected in relation to transfusion technique. CONCLUSIONS Delivery of autologous canine RBCs via mechanical delivery systems was associated with a high risk for early loss of transfused cells.
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Affiliation(s)
- Ruth I McDevitt
- Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR 97330, USA
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38
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Prittie JE. Controversies related to red blood cell transfusion in critically ill patients. J Vet Emerg Crit Care (San Antonio) 2010; 20:167-76. [PMID: 20487245 DOI: 10.1111/j.1476-4431.2010.00521.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To review the evolution of and controversies associated with allogenic blood transfusion in critically ill patients. DATA SOURCES Veterinary and human literature review. HUMAN DATA SYNTHESIS RBC transfusion practices for ICU patients have come under scrutiny in the last 2 decades. Human trials have demonstrated relative tolerance to severe, euvolemic anemia and a significant outcome advantage following implementation of more restricted transfusion therapy. Investigators question the ability of RBCs stored longer than 2 weeks to improve tissue oxygenation, and theorize that both age and proinflammatory or immunomodulating effects of transfused cells may limit efficacy and contribute to increased patient morbidity and mortality. Also controversial is the ability of pre- and post-storage leukoreduction of RBCs to mitigate adverse transfusion-related events. VETERINARY DATA SYNTHESIS While there are several studies evaluating the transfusion trigger, the RBC storage lesion and transfusion-related immunomodulation in experimental animal models, there is little research pertaining to clinical veterinary patients. CONCLUSIONS RBC transfusion is unequivocally indicated for treatment of anemic hypoxia. However, critical hemoglobin or Hct below which all critically ill patients require transfusion has not been established and there are inherent risks associated with allogenic blood transfusion. Clinical trials designed to evaluate the effects of RBC age and leukoreduction on veterinary patient outcome are warranted. Implementation of evidence-based transfusion guidelines and consideration of alternatives to allogenic blood transfusion are advisable.
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Affiliation(s)
- Jennifer E Prittie
- Department of Emergency and Critical Care, Animal Medical Center, New York, NY 10065, USA.
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39
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McMichael M, Smith S, Galligan A, Swanson K, Fan T. Effect of Leukoreduction on Transfusion-Induced Inflammation in Dogs. J Vet Intern Med 2010; 24:1131-7. [DOI: 10.1111/j.1939-1676.2010.0561.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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40
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Tasaki T, Ohto H, Sasaki S, Kanno T, Igari T, Hoshi Y. Significance of pre-storage leucoreduction for autologous blood. Vox Sang 2009; 96:226-33. [DOI: 10.1111/j.1423-0410.2008.01139.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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41
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Tabar MD, Roura X, Francino O, Altet L, Ruiz de Gopegui R. Detection of Leishmania infantum by real-time PCR in a canine blood bank. J Small Anim Pract 2008; 49:325-8. [PMID: 18422503 DOI: 10.1111/j.1748-5827.2008.00542.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Risk for transmission of Leishmania infantum from blood products has been largely demonstrated in human and veterinary literature. Appropriate screening of canine blood donors is important especially in an endemic area such as Barcelona (Spain). The purpose of this study was to evaluate the presence of L infantum DNA parasites by real-time quantitative PCR in our canine blood bank. METHODS Samples from blood products obtained from 92 canine blood donors were assayed for L infantum by means of real-time PCR amplification and quantification. RESULTS The prevalence of quantitative PCR-positive blood samples among healthy seronegative blood donors was 19.6 per cent. CLINICAL SIGNIFICANCE The results of this study show that L infantum infection is common in canine blood donors and their blood products in an endemic area, despite a negative commercial serological screening for infectious diseases. Therefore, screening by PCR should be included in an integrated approach to evaluate L infantum infection among potential blood donors.
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Affiliation(s)
- M D Tabar
- Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine of Barcelona, Barcelona, Spain
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42
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Blood Transfusion and Blood Substitutes. FLUID, ELECTROLYTE, AND ACID-BASE DISORDERS IN SMALL ANIMAL PRACTICE 2006. [PMCID: PMC7149518 DOI: 10.1016/b0-72-163949-6/50027-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
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Tzimas GN, Deschenes M, Barkun JS, Wong P, Tchervenkov JI, Hayati H, Alpert E, Metrakos P. Leukoreduction and acute rejection in liver transplantation: An interim analysis. Transplant Proc 2004; 36:1760-2. [PMID: 15350471 DOI: 10.1016/j.transproceed.2004.07.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Little is known about the effect of blood transfusions and leukoreduction on acute rejection in liver transplantation. The purpose of this study was to assess the impact of leukoreduction on the occurrence of early rejection episodes in liver transplantation. METHODS In 1999, mandatory leukoreduction was implemented in our program. Data from 339 consecutive liver transplant recipients were analyzed with attention to the time period as a proxy for leukoreduction, the number of transfusions, the wait list status, the hepatitis B or C status, the recipient age, and the type of immunosuppression. RESULTS Using an early (6-month) rejection-free graft survival model, we observed that introduction of leukoreduction was independently associated with fewer rejection episodes (P =.001). Despite the lower rejection rate, due to a regimen of tacrolimus and antithymocyte globulin, the effect of implementation of leukoreduction remained significant (P =.021). CONCLUSION The use of leukoreduction is associated with fewer early rejections, irrespective of the type of immunosuppression. These data support an exploration of the immunomodulatory effect of leukoreduction.
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Affiliation(s)
- G N Tzimas
- Department of General Surgery, Section of Transplantation, Montreal, Quebec, Canada
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Abstract
In the perioperative period, blood transfusions are most commonly administered to address acute blood loss resulting from trauma, neoplasia, or surgery. In this setting, transfusions may be life saving, allowing time for clotting or surgical hemostasis. In recent years, however, there is a growing awareness that the administration of blood products may not be a benign treatment. In addition to the more commonly cited complications such as transfusion reactions, disease transmission, and electrolyte disturbances, blood transfusions have also been linked to poor surgical outcomes, increased risk of infection, cancer recurrence, and acute lung injury. The recognition of these problems has lead to more conservative transfusion strategies, and questioning of what constitutes an appropriate transfusion trigger. In this section, we will discuss the pathophysiology of acute blood loss, the benefits and risks of transfusions in surgical patients, management of perioperative blood transfusions, and alternative strategies to minimize the need for blood products.
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Affiliation(s)
- L Ari Jutkowitz
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing 48824-1314, USA.
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Prittie JE. Triggers for use, optimal dosing, and problems associated with red cell transfusions. Vet Clin North Am Small Anim Pract 2003; 33:1261-75. [PMID: 14664198 DOI: 10.1016/s0195-5616(03)00093-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The administration of RBC components can dramatically improve tissue oxygenation in small animals with symptomatic anemia and can be life saving. This therapy is not without risk, however. Careful consideration of the transfusion trigger, appropriate screening of the donor and recipient, and selection of the optimal RBC component and dose on an individual patient basis can help to limit the occurrence of adverse transfusion-related events. Appropriate component administration techniques, careful monitoring of recipients for the development of transfusion reactions, and prompt recognition and treatment of transfusion reactions are also essential in assuring safe transfusion practice.
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Affiliation(s)
- Jennifer E Prittie
- Department of Emergency and Critical Care, Animal Medical Center, 510 East 62nd Street, New York, NY 10021, USA.
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Tsuchiya R, Yagura H, Hachiya Y, Mochizuki T, Furuichi M, Hisasue M, Kobayashi K, Yamada T. Aggregability and post-transfusion survival of canine platelets in stored whole blood. J Vet Med Sci 2003; 65:825-9. [PMID: 12951412 DOI: 10.1292/jvms.65.825] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The effects of whole blood storage time on platelet aggregation and on post-transfusion platelet survival time were assessed in dogs. Citrate phosphate dextrose adenine-1 (CPDA-1) was used as a blood cell preservative. Storage time dependent decay of platelet aggregability was assessed. Platelet aggregation responses to collagen and ADP were maintained for at least 8 hr at room temperature. During blood storage, immunoglobulin became nonspecifically bound to platelets, suggesting the potential for immune destruction of platelets by the mononuclear phagocyte system after transfusion. To assess this assumption, the survival times of infused platelets, which were stored for 0 to 8 hr in whole blood, were measured. Post-transfusion survival of platelets was not affected by these storage times. These results suggest that canine platelets maintain viability when stored at room temperature for up to 8 hr in CPDA-1 treated whole blood intended for transfusion.
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Affiliation(s)
- Ryo Tsuchiya
- School of Veterinary Medicine, Azabu University, Fuchinobe, Sagamihara, Kanagawa, Japan
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