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Obonyo NG, Dhanapathy V, White N, Sela DP, Rachakonda RH, Tunbridge M, Sim B, Teo D, Nadeem Z, See Hoe LE, Bassi GL, Fanning JP, Tung JP, Suen JY, Fraser JF. Effects of red blood cell transfusion on patients undergoing cardiac surgery in Queensland - a retrospective cohort study. J Cardiothorac Surg 2024; 19:475. [PMID: 39090687 PMCID: PMC11293042 DOI: 10.1186/s13019-024-02974-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 07/13/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Packed red blood cell (pRBC) transfusion is a relatively safe and mainstay treatment commonly used in cardiac surgical patients. However, there is limited evidence on clinical effects of transfusing blood nearing end-of shelf life that has undergone biochemical changes during storage. OBJECTIVE To investigate evidence of associations between morbidity/mortality and transfusion of blood near end of shelf-life (> 35 days) in cardiac surgical patients. METHODS Data from the Queensland Health Admitted Patient Data Collection database 2007-2013 was retrospectively analysed. Coronary artery bypass graft and valvular repair patients were included. Multivariable logistic regression was used to examine the effect of pRBC age (< 35 days vs. ≥ 35 days) on in-hospital mortality and morbidity. As secondary analysis, outcomes associated with the number of pRBC units transfused (≤ 4 units vs. ≥ 5 units) were also assessed. RESULTS A total of 4514 cardiac surgery patients received pRBC transfusion. Of these, 292 (6.5%) received pRBCs ≥ 35 days. No difference in in-hospital mortality or frequency of complications was observed. Transfusion of ≥ 5 units of pRBCs compared to the ≤ 4 units was associated with higher rates of in-hospital mortality (5.6% vs. 1.3%), acute renal failure (17.6% vs. 8%), infection (10% vs. 3.4%), and acute myocardial infarction (9.2% vs. 4.3%). Infection carried an odds ratio of 1.37 between groups (CI = 0.9-2.09; p = 0.14) and stroke/neurological complications, 1.59 (CI = 0.96-2.63; p = 0.07). CONCLUSION In cardiac surgery patients, transfusion of pRBCs closer to end of shelf-life was not shown to be associated with significantly increased mortality or morbidity. Dose-dependent differences in adverse outcomes (particularly where units transfused were > 4) were supported.
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Affiliation(s)
- Nchafatso G Obonyo
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.
- Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia.
- Initiative to Develop African Research Leaders (IDeAL), KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
- Wellcome Trust Centre for Global Health Research, Imperial College London, London, UK.
- Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
| | - Vikash Dhanapathy
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- School of Medicine, Griffith University, Gold Coast, QLD, Australia
| | - Nicole White
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Declan P Sela
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Reema H Rachakonda
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Matthew Tunbridge
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Beatrice Sim
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Derek Teo
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Zohaib Nadeem
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Louise E See Hoe
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Gianluigi Li Bassi
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
- Wesley Medical Research, The Wesley Foundation, Auchenflower, Brisbane, QLD, Australia
- Intensive Care Unit, St Andrew's War Memorial Hospital, Spring Hill, Brisbane, QLD, Australia
- Intensive Care Unit, The Wesley Hospital, Auchenflower, Brisbane, QLD, Australia
- Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jonathon P Fanning
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - John-Paul Tung
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
- Clinical Services and Research, Australian Red Cross Lifeblood, Brisbane, QLD, Australia
- Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jacky Y Suen
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - John F Fraser
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
- Intensive Care Unit, St Andrew's War Memorial Hospital, Spring Hill, Brisbane, QLD, Australia
- Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
- School of Medicine, Griffith University, Gold Coast, QLD, Australia
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Camargo Castillo MA, de Almeida BA, Wissmann D, Moreira RF, Okano FY, Gonzalez FHD, Soares JF, de Faria Valle S. Viability of erythrocytes in canine packed red blood cells stored in CPDA-1 is related to the presence of Mycoplasma haemocanis. Comp Immunol Microbiol Infect Dis 2023; 97:101982. [PMID: 37120937 DOI: 10.1016/j.cimid.2023.101982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 04/12/2023] [Indexed: 05/02/2023]
Abstract
Hemotropic mycoplasmas are associated with subclinical disease in dogs and should be identified in blood donors. The objective was to investigate the presence and effect of M. haemocanis in units of packed red blood cells (pRBC) during storage. Canine donors (n = 10) were screened for M. haemocanis by quantitative real-time PCR. pRBCs were obtained from 5 hemoplasma negative dogs and 5 hemoplasma positive dogs. Each pRBC was aliquoted into two 100 mL transfer bags and stored at 4 °C. M. haemocanis loads and biochemical variables (pH, bicarbonate, potassium, sodium, chlorite, glucose, lactate, ammonia, PCV, and % hemolysis) were evaluated on days 1, 7, 18, and 29. M. haemocanis loads increased in pRBC from day 1-29 of storage. Glucose decreased and lactate increase faster in pRBC with M. haemocanis. This study contributes to understand hemoplasma metabolism and reinforces that dog donors should be tested for hemoplasmas.
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Affiliation(s)
- Monica A Camargo Castillo
- Department of Veterinary Clinical Pathology, School of Veterinary Medicine, UFRGS, Porto Alegre RS, Brazil
| | | | - Daiani Wissmann
- Department of Veterinary Clinical Pathology, School of Veterinary Medicine, UFRGS, Porto Alegre RS, Brazil
| | - Renata Fagundes Moreira
- Department of Veterinary Clinical Pathology, School of Veterinary Medicine, UFRGS, Porto Alegre RS, Brazil
| | - Felipe Yuki Okano
- Department of Veterinary Clinical Pathology, School of Veterinary Medicine, UFRGS, Porto Alegre RS, Brazil
| | - Felix H D Gonzalez
- Department of Veterinary Clinical Pathology, School of Veterinary Medicine, UFRGS, Porto Alegre RS, Brazil
| | - João Fábio Soares
- Department of Veterinary Clinical Pathology, School of Veterinary Medicine, UFRGS, Porto Alegre RS, Brazil
| | - Stella de Faria Valle
- Department of Veterinary Clinical Pathology, School of Veterinary Medicine, UFRGS, Porto Alegre RS, Brazil.
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da Costa A, de Carvalho CA, Nascimento ND, de Andrade HF. Scavenger receptors mediate increased uptake of irradiated T.gondii extracts by J774 macrophages. Int J Radiat Biol 2023; 99:1559-1569. [PMID: 36862984 DOI: 10.1080/09553002.2023.2187475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/20/2023] [Indexed: 03/04/2023]
Abstract
PURPOSE Protein extracts developed increased immunogenicity without the aid of adjuvants after gamma irradiation. Gamma irradiation of snake venom increased antivenin production by detoxification and enhanced immunity, probably due preferential uptake of irradiated venoms by macrophage scavenger receptors. We studied this uptake of irradiated soluble Toxoplasma gondii extract (STag) by the J774 macrophage cell line similar to antigen presenting cells. MATERIAL AND METHODS We labeled STag by biosynthesis in living tachyzoites with radioactive amino acids before purification and irradiation or by adding labels as biotin or fluorescein in stored STag, for quantitative studies or subcellular distribution visualization. RESULTS There was enhanced binding and uptake of irradiated STag into the cells compared to non-irradiated STag. Using fluorescein labeled antigens and morphological assays, we confirmed that cells avidly ingested both native and irradiated proteins but native STag were digested after ingestion while irradiated proteins remained in the cell, suggesting diverse intracytoplasmic pathways. Native or irradiated STag present the same in vitro sensitivity to three types of peptidases. Inhibitors of scavenger receptors (SRs) such as Dextran sulfate (SR-A1 blocker) or Probucol (SR-B blocker) affect the specific uptake of irradiated antigens, suggesting its association with enhanced immunity. CONCLUSIONS Our data suggests that cell SRs recognize irradiated proteins, mainly SRs for oxidized proteins, leading to antigen uptake by an intracytoplasmic pathway with fewer peptidases that prolongs presentation to nascent major histocompatibility complex I or II and enhances immunity by better antigen presentation.
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Affiliation(s)
- Andrea da Costa
- Laboratório de Protozoologia, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, Brazil
| | | | - Nanci do Nascimento
- Centro de Biotecnologia, Instituto de Pesquisa Energéticas e Nucleares, IPEN/CNEN-SP, Sao Paulo, Brazil
| | - Heitor Franco de Andrade
- Laboratório de Protozoologia, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, Brazil
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Askar MA, Guida MS, AbuNour SM, Ragab EA, Ali EN, Abdel-Magied N, Mansour NA, Elmasry SA. Nanoparticles for active combination radio mitigating agents of zinc coumarate and zinc caffeinate in a rat model. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:30233-30248. [PMID: 35000180 DOI: 10.1007/s11356-021-18411-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 12/26/2021] [Indexed: 06/14/2023]
Abstract
Zinc coumarate and zinc caffeinate nanoparticles (ZnCoNPs, ZnCaNPs) affect different biological processes. This study aimed to evaluate the mitigating action of ZnCoNPs in combination with ZnCaNPs against liver damage induced by gamma rays (γ-rays). Rats were exposed to 7 Gy of γ-rays and then injected intraperitoneally (i.p) with ZnCoNPs [2U/rat/day (5 mg/kg)] and ZnCaNPs [2U/rat/day (15 mg/kg)] for 7 consecutive days. The results showed that irradiated rats treated with ZnCoNPs (5 mg/kg/body weight) in combination with ZnCaNPs (15 mg/kg/body weight) for 7 days had a significant increases in body weight, antioxidant levels, T helper cell 4 (cluster of differentiation 4 (CD4)), and T cytotoxic cell 8 (cluster of differentiation 8 (CD8)), associated with a marked decrease in lipid peroxidation (LP), nitric oxide(NOx), total free radicals concentrate (TFRC), and DNA fragmentation. There were positive alterations in the morphological state, hematological parameters and the cell cycle phases. Additionally, the histopathological study demonstrated an improvement in the liver tissue of irradiated rats after treatment. Thus, ZnCoNPs and ZnCaNPs could be used as natural mitigating agents to reduce the hazards of ionizing radiation.
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Affiliation(s)
- Mostafa A Askar
- Department of Radiation Biology Research, National Centre for Radiation Research and Technology (NCRRT), Atomic Energy Authority, Cairo, Egypt
| | - Mona S Guida
- GenticUnit, Pediatric Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Seham M AbuNour
- Department of Health and Radiation Research, National Centre for Radiation Research and Technology (NCRRT), Atomic Energy Authority, Cairo, Egypt
| | - Essam A Ragab
- Department of Natural Product Research, National Centre for Radiation Research and Technology (NCRRT), Atomic Energy Authority, Cairo, Egypt
| | - Eiman N Ali
- Department of Radiation Biology Research, National Centre for Radiation Research and Technology (NCRRT), Atomic Energy Authority, Cairo, Egypt
| | - Nadia Abdel-Magied
- Department of Radiation Biology Research, National Centre for Radiation Research and Technology (NCRRT), Atomic Energy Authority, Cairo, Egypt.
| | - Nahla A Mansour
- Petrochemical Department, Egyptian Petroleum Research Institute, Nasr City, Cairo, Egypt
| | - Samir A Elmasry
- Department of Molecular Biology, Genetic Engineering & Biotechnology Research Institute, Sadat City, Egypt
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Rodriguez JV, Tormey CA. Can transfusion-associated graft-versus-host disease (TA-GvHD) be prevented with leukoreduction alone? Transfus Apher Sci 2022; 61:103402. [DOI: 10.1016/j.transci.2022.103402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Balasubramanyam P, Basavarajegowda A, Hanumanthappa N, Negi VS, Harichandrakumar KT. Irradiating stored blood and storing irradiated blood: Is it different? - A study of serial changes in biochemical parameters of red blood cell units. Asian J Transfus Sci 2021; 15:172-178. [PMID: 34908750 PMCID: PMC8628233 DOI: 10.4103/ajts.ajts_71_21] [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: 06/09/2021] [Revised: 07/04/2021] [Accepted: 07/11/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Gamma Irradiation of blood products accentuates biochemical changes in the blood stored at 4°C. This study tried to compare the changes in potassium, sodium, glucose, lactate, and lactate dehydrogenase (LDH) levels in packed red blood cell (PRBC) units irradiated at various time points and then stored versus those stored for a particular period then irradiated. METHODOLOGY One hundred and eighty units of RBCs were randomly assigned equally to be irradiated or not. Eighteen units each were irradiated by gamma irradiator using cobalt 60 (BI 2000) on day 1, 7, 14, 21, and 28 of their storage, respectively, in the irradiation group. All the units were assessed for their plasma levels of potassium, sodium, glucose, LDH, and lactate by clinical chemistry auto analyzer Beckman coulter AU680 weekly. The values were documented and analyzed by SPSS. RESULTS Baseline values on day 1 for studied biochemical parameters were comparable between irradiated and nonirradiated groups. Mean values of potassium, lactate and LDH were higher in irradiated than nonirradiated PRBC bags. In contrast, Sodium and Glucose mean values were lower than baseline values. Maximum cumulative mean values were noted in day-21 irradiated bags when the parameters were measured on day-28 for potassium and lactate levels. This was followed by day 14 irradiated bags, followed by day 7 irradiated bags. CONCLUSION The study indicates that irradiation of red cells later in their storage period had comparatively more detrimental changes in relation to potassium and lactate than irradiation in earlier days. Consideration of irradiation to be performed as close to the issue as possible to reduce a lesser number of days of storage postirradiation is to be explored.
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Affiliation(s)
- Pramanya Balasubramanyam
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Nandeesha Hanumanthappa
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Vir Singh Negi
- Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - K T Harichandrakumar
- Department of Biostatistics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Orsi KCSC, Kita VY, de Souza AHP, Tsunemi MH, Avelar AFM. Neonatal Transfusion Practice: Hemolysis Markers After In Vitro Infusion of Packed Red Blood Cells by the Gravitational Method or Syringe Pump in a Peripheral Catheter. J Perinat Neonatal Nurs 2021; 35:E40-E49. [PMID: 34726655 DOI: 10.1097/jpn.0000000000000571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The objective of this study was to verify the influence of the gravitational infusion method or syringe infusion pump on changes in hemolysis markers of irradiated and nonirradiated packed red blood cells (PRBCs) in vitro administered in a neonate peripheral intravenous catheter. An experimental study was conducted in a laboratory under controlled environmental conditions. Irradiated and nonirradiated PRBCs were administered in triplicate by the gravitational method and 10-mL/hour syringe infusion pump, in peripheral intravenous catheter, Vialon, 24-G caliber. Aliquots were collected directly from the PRBC bag, after manual filling of the infusion system and after infusion by the catheters. The following hemolytic markers were analyzed: degree of hemolysis (%), hematocrit (Ht, %), free hemoglobin (fHb, g/dL), potassium (K, mmol/L), and lactate dehydrogenase (LDH, U/L). Mann-Whitney and Student's t tests were used, P ≤ .05. The gravitational method significantly influenced increasing fHb (P = .007), Ht (P = .002), K (P = .002), and LDH (P = .003) values after PRBC irradiated infusion. The infusion of irradiated and non-irradiated PRBCs interferes with changes in hemolytic markers with the gravitational method. Syringe infusion pump proved to be a beneficial and safe alternative to irradiated and nonirradiated PRBC transfusion in newborns.
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Affiliation(s)
- Kelly Cristina Sbampato Calado Orsi
- Nursing School, Federal University of São Paulo, São Paulo, Brazil (Drs Orsi and Avelar and Mss Kita and de Souza); and Department of Biostatistics, Paulista State University Julio de Mesquita Filho, Botucatu, São Paulo, Brazil (Dr Tsunemi)
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Barzegar S, Rezvani MR, Safa M, Amani A, Abbaspour A, Pourfathollah A, Hashemi J, Zaker F. Dose-dependent efficacy of antioxidant nanoparticles on red blood cells storage. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:256. [PMID: 34485553 PMCID: PMC8395988 DOI: 10.4103/jehp.jehp_1638_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 12/27/2020] [Indexed: 05/05/2023]
Abstract
BACKGROUND Transfusion of healthy red blood cells (RBCs) after storage is important. One of the storage lesions on blood bags is oxidative stress. One way to prevent increased oxidative stress is to use antioxidant nanoparticles (NPs). Superoxide dismutase (SOD) and catalase (CAT) play an important role in antioxidant defense on RBC. poly lactic-co-glycolic acid (PLGA) is a nontoxic biodegradable polymer that is approved by the Food and Drug Administration for drug delivery. This study aimed to assess dose-dependent efficacy of SOD-CAT-polyethylene glycol -PLGA on RBCs storage. MATERIALS AND METHODS Using a descriptive study, during 1 month, twenty donors from Bojnourd Blood Donation Center were selected. NPs with different concentrations were injected into the satellite bags after directing blood to them. On target days, experiments were performed on the samples taken. Electrospray was employed to prepare SOD-CAT-PLGA NPs. Twenty packed RBCs were isolated from the whole blood bags by the mechanical method, and certain amount of product was transferred to the satellite bags. On days 1, 7, 14, 21, 28, and 35, bags were sampled. Malondialdehyde (MDA), prooxidant-antioxidant balance (PAB), and Annexin V were performed on the samples taken. The repeated measures analysis with the help of SPSS software version 20 was performed on samples. RESULTS MDA increased in both groups. The maximum increase in test group was seen in concentration 12 mg (MDA Day 14, test [1.93 ± 0.3], [P MDA < 0.001]). Maximum increase in PAB was seen in concentration 12 mg (from 444 ± 1.7 to 563 ± 2.5) (P PAB = 0.000). Furthermore, PS expression increased in the concentration of 12 mg greater than other concentration in consecutive (from 5.00 ± 0.8 to 22.26 ± 1.7, [P < 0.001]). CONCLUSION Evaluation of dose dependency showed that different concentrations of antioxidant NPs affect RBC. This effect can be changed oxidative stress and apoptosis. Using both changes to evaluate functional and toxicity can be helpful.
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Affiliation(s)
- Saeid Barzegar
- Department of Hematology, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Rezvani
- Department of Hematology, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
- Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
- Department of Oncology-Pathology, Immune and Gene Therapy Lab, Cancer Center Karolinska, Karolinska University Hospital Solna and Karolinska Institute, Stockholm, Sweden
| | - Majid Safa
- Department of Hematology, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Amani
- Department of Biotechnology , School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Alireza Abbaspour
- Department of Pathobiology and Laboratory Sciences, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Aliakbar Pourfathollah
- Department of Immunology, School of Medicine, Iranian Blood Transfusion Research Center, Tarbiat Modares University, Tehran, Iran
| | - Javad Hashemi
- Department of Pathobiology and Laboratory Sciences, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Farhad Zaker
- Department of Hematology, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
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Schneck E, Muelich M, Markmann M, Edinger F, Cooper N, Moeller A, Bein G, Hecker A, Koch C, Sander M, Wolff M. Combined Administration of Fibrinogen and Factor XIII Concentrate Does Not Improve Dilutional Coagulopathy Superiorly Than Sole Fibrinogen Therapy: Results of an In-Vitro Thrombelastographic Study. J Clin Med 2021; 10:jcm10102068. [PMID: 34065924 PMCID: PMC8150940 DOI: 10.3390/jcm10102068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 11/16/2022] Open
Abstract
The early administration of fibrinogen has gained wide acceptance for the treatment of major hemorrhage, whereas the substitution of coagulation factor XIII (FXIII) is only supported by a low level of evidence. This study aimed to answer the question of whether a combined therapy of fibrinogen/FXIII substitution performs superiorly to sole fibrinogen administration in the treatment of dilutional coagulopathy. An in-vitro model of massive transfusion was used to compare the effect of combined fibrinogen/FXIII administration to that of sole fibrinogen therapy for the treatment of dilutional coagulopathy. For this purpose, the blood of red blood cell concentrates, fresh frozen plasma, and platelet concentrates were reconstituted in a ratio of 4:4:1, and then diluted with gelatin by 20% and 40%, respectively. Clot formation and stability were analyzed by thrombelastography. Both sole fibrinogen therapy (equivalent to 50 mg/kg) and the combined administration of fibrinogen (equivalent to 50 mg/kg) and FXIII (equivalent to 75 International Units (IU)/kg) increased fibrinogen-dependent mean clot firmness independently of the degree of dilution (20% dilution: 7 (6.3–7.8) mm; 20% dilution fibrinogen: 13.5 (13–17.3) mm; 20% dilution fibrinogen/FXIII: 16.5 (15.3–18.8) mm; 40% dilution: 3 (2–3.8) mm; 40% dilution fibrinogen: 8 (7–11.3) mm; 40% dilution fibrinogen/FXIII: 10 (8.3–11.8) mm; all p < 0.01). However, no differences were identified between the two treatment arms. Compared to fibrinogen therapy, no beneficial effect of the combined administration of fibrinogen and FXIII for the treatment of dilutional coagulopathy was detected in this in-vitro massive transfusion model. The result was independent of the degree of dilution.
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Affiliation(s)
- Emmanuel Schneck
- Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital of Giessen, 35392 Giessen, Germany; (M.M.); (M.M.); (F.E.); (C.K.); (M.S.); (M.W.)
- Correspondence: ; Tel.: +49-641-985-44401
| | - Marcus Muelich
- Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital of Giessen, 35392 Giessen, Germany; (M.M.); (M.M.); (F.E.); (C.K.); (M.S.); (M.W.)
| | - Melanie Markmann
- Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital of Giessen, 35392 Giessen, Germany; (M.M.); (M.M.); (F.E.); (C.K.); (M.S.); (M.W.)
| | - Fabian Edinger
- Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital of Giessen, 35392 Giessen, Germany; (M.M.); (M.M.); (F.E.); (C.K.); (M.S.); (M.W.)
| | - Nina Cooper
- Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, 35392 Giessen, Germany; (N.C.); (A.M.); (G.B.)
| | - Annette Moeller
- Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, 35392 Giessen, Germany; (N.C.); (A.M.); (G.B.)
| | - Gregor Bein
- Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, 35392 Giessen, Germany; (N.C.); (A.M.); (G.B.)
| | - Andreas Hecker
- Department of General & Thoracic Surgery, University Hospital of Giessen, 35392 Giessen, Germany;
| | - Christian Koch
- Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital of Giessen, 35392 Giessen, Germany; (M.M.); (M.M.); (F.E.); (C.K.); (M.S.); (M.W.)
| | - Michael Sander
- Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital of Giessen, 35392 Giessen, Germany; (M.M.); (M.M.); (F.E.); (C.K.); (M.S.); (M.W.)
| | - Matthias Wolff
- Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital of Giessen, 35392 Giessen, Germany; (M.M.); (M.M.); (F.E.); (C.K.); (M.S.); (M.W.)
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Cognasse F, Hally K, Fauteux-Daniel S, Eyraud MA, Arthaud CA, Fagan J, Mismetti P, Hamzeh-Cognasse H, Laradi S, Garraud O, Larsen P. Effects and Side Effects of Platelet Transfusion. Hamostaseologie 2021; 41:128-135. [PMID: 33711849 DOI: 10.1055/a-1347-6551] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Aside from their canonical role in hemostasis, it is increasingly recognized that platelets have inflammatory functions and can regulate both adaptive and innate immune responses. The main topic this review aims to cover is the proinflammatory effects and side effects of platelet transfusion. Platelets prepared for transfusion are subject to stress injury upon collection, preparation, and storage. With these types of stress, they undergo morphologic, metabolic, and functional modulations which are likely to induce platelet activation and the release of biological response modifiers (BRMs). As a consequence, platelet concentrates (PCs) accumulate BRMs during processing and storage, and these BRMs are ultimately transfused alongside platelets. It has been shown that BRMs present in PCs can induce immune responses and posttransfusion reactions in the transfusion recipient. Several recent reports within the transfusion literature have investigated the concept of platelets as immune cells. Nevertheless, current and future investigations will face the challenge of encompassing the immunological role of platelets in the scope of transfusion.
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Affiliation(s)
- Fabrice Cognasse
- Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France.,SAINBIOSE, INSERM U1059, University of Lyon, Université Jean-Monnet-Saint-Etienne, France, France
| | - Kathryn Hally
- Department of Surgery and Anaesthesia, University of Otago, Wellington, New Zealand.,Wellington Cardiovascular Research Group, Wellington, New Zealand.,School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand
| | - Sebastien Fauteux-Daniel
- Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France.,SAINBIOSE, INSERM U1059, University of Lyon, Université Jean-Monnet-Saint-Etienne, France, France
| | - Marie-Ange Eyraud
- Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France.,SAINBIOSE, INSERM U1059, University of Lyon, Université Jean-Monnet-Saint-Etienne, France, France
| | - Charles-Antoine Arthaud
- Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France.,SAINBIOSE, INSERM U1059, University of Lyon, Université Jean-Monnet-Saint-Etienne, France, France
| | - Jocelyne Fagan
- Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France.,SAINBIOSE, INSERM U1059, University of Lyon, Université Jean-Monnet-Saint-Etienne, France, France
| | - Patrick Mismetti
- SAINBIOSE, INSERM U1059, University of Lyon, Université Jean-Monnet-Saint-Etienne, France, France
| | - Hind Hamzeh-Cognasse
- SAINBIOSE, INSERM U1059, University of Lyon, Université Jean-Monnet-Saint-Etienne, France, France
| | - Sandrine Laradi
- Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France.,SAINBIOSE, INSERM U1059, University of Lyon, Université Jean-Monnet-Saint-Etienne, France, France
| | - Olivier Garraud
- SAINBIOSE, INSERM U1059, University of Lyon, Université Jean-Monnet-Saint-Etienne, France, France
| | - Peter Larsen
- Department of Surgery and Anaesthesia, University of Otago, Wellington, New Zealand.,Wellington Cardiovascular Research Group, Wellington, New Zealand.,School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand
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11
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Eshghifar N, Maghsudlu M, Amini Kafi-Abad S. The Effect of Pre-Storage Irradiation Blood on Quality of Red Blood Cells. Int J Hematol Oncol Stem Cell Res 2021; 15:1-6. [PMID: 33613895 PMCID: PMC7885131 DOI: 10.18502/ijhoscr.v15i1.5244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Irradiation leads to increased storage lesions that may have harmful effects if transfused. Various storage lesions research has been carried out, and only very few articles are available on the impact of gamma irradiation on RBC storage lesions. Since there has been no study about finding the best time for irradiation, we decided to investigate the effect of irradiation on Red blood cells at different storage times after blood collection Materials and Methods: A total of 40 units of red blood cells divided into two groups, irradiated and non-irradiated. Irradiated RBCs were divided into three groups and each group containing ten units. The remaining ten units were considered as non-irradiated controls. Sampling from these irradiated and non-irradiated blood units was performed weekly to evaluate biochemical parameters and free plasma hemoglobin/Hemolysis index levels. Results: A significant increase in the mean values of plasma potassium, plasma Hb/Hemolysis index, and LDH, as well as a significant reduction in the mean value of 2,3 DPG and plasma sodium, were observed in both groups. Although the reduction of 2,3 DPG is extremely remarkable, it is compensated 24-48 hours after transfusion. Hence, the clinical result of 2,3-DPG-depleted RBC transfusion is known to be negligible. The irradiation group alteration was more notable than the non-irradiated one and the changes in the parameters were most significant in the group having been stored for a longer period after irradiation. Conclusion: Our investigation on the impact of gamma irradiation on RBCs makes it possible to suggest a storage time up to 28 days after irradiation is permissible and the best time for irradiation after blood collection is up to 14 days. It is pointed out that the blood unit should be transfused as soon as possible after the irradiation.
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Affiliation(s)
- Nahal Eshghifar
- Department of Cellular and Molecular Biology, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Mahtab Maghsudlu
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Sedigheh Amini Kafi-Abad
- Department of Pathology, Iranian Blood Transfusion Organization, Research Centre, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
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12
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Marabi PM, Musyoki S, Amayo A. Biochemical changes in whole blood stored for transfusion at Bungoma County Referral Hospital, Kenya. Afr J Lab Med 2020; 9:1182. [PMID: 33392054 PMCID: PMC7756861 DOI: 10.4102/ajlm.v9i1.1182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 10/14/2020] [Indexed: 11/16/2022] Open
Abstract
Background During storage, transfusion blood may undergo a series of biochemical changes that could pose risks to patients when used. It is important therefore to monitor biochemical changes that may reduce survival or function of stored blood cells. Objective This study assessed biochemical changes in whole blood stored for transfusion at Bungoma County Referral Hospital in the western region of Kenya between February 2019 and August 2019. Methods A prospective study design involving 20 randomly selected donor blood units in citrate phosphate dextrose adenine anticoagulant was employed. Biochemical changes were evaluated for 35 days. Potassium and sodium levels were tested using the HumaLyte Plus5 analyser. Blood pH level was estimated using the Hanna pH meter. Results At the end of the 35 days of storage under blood bank conditions, the mean potassium level significantly increased from 7.31 mmol/L at baseline to 20.14 mmol/L at week 5 (p < 0.0001), and the mean sodium level significantly decreased from 150.72 mmol/L at baseline to 121.56 mmol/L at week 5 (p < 0.0001). The pH level decreased insignificantly from 7.48 at baseline to 7.38 at the end of week 1 (p = 0.0757) but decreased significantly to 6.15 at the end of week 5 (p < 0.0001). Conclusion Potassium increased and sodium concentrations decreased significantly from the first week of blood storage. The pH decreased significantly from the second week of storage. Therefore, aged blood should be avoided to circumvent potential adverse outcomes from biochemical changes and stored blood should be tested before use.
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Affiliation(s)
- Phidelis M Marabi
- Department of Health, Bungoma County Referral Hospital, Bungoma, Kenya.,School of Health Sciences, Kisii University, Kisii, Kenya
| | | | - Angela Amayo
- Department of Human Pathology, Faculty of Health Sciences, University of Nairobi, Nairobi, Kenya
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13
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Mykhailova O, Olafson C, Turner TR, DʼAlessandro A, Acker JP. Donor-dependent aging of young and old red blood cell subpopulations: Metabolic and functional heterogeneity. Transfusion 2020; 60:2633-2646. [PMID: 32812244 DOI: 10.1111/trf.16017] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/08/2020] [Accepted: 07/08/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Characteristics of red blood cells (RBCs) are influenced by donor variability. This study assessed quality and metabolomic variables of RBC subpopulations of varied biologic age in red blood cell concentrates (RCCs) from male and female donors to evaluate their contribution to the storage lesion. STUDY DESIGN AND METHODS Red blood cell concentrates from healthy male (n = 6) and female (n = 4) donors were Percoll separated into less dense ("young", Y-RCCs) and dense ("old", O-RCCs) subpopulations, which were assessed weekly for 28 days for changes in hemolysis, mean cell volume (MCV), hemoglobin concentration (MCHC), hemoglobin autofluorescence (HGB), morphology index (MI), oxygen affinity (p50), rigidity, intracellular reactive oxygen species (ROS), calcium ([Ca2+ ]), and mass spectrometry-based metabolomics. RESULTS Young RCCs having disc-to-discoid morphology showed higher MCV and MI, but lower MCHC, HGB, and rigidity than O-RCCs, having discoid-to-spheroid shape. By Day 14, Y-RCCs retained lower hemolysis and rigidity and higher p50 compared to O-RCCs. Donor sex analyses indicated that females had higher MCV, HGB, ROS, and [Ca2+ ] and lower hemolysis than male RBCs, in addition to having a decreased rate of change in hemolysis by Day 28. Metabolic profiling indicated a significant sex-related signature across all groups with increased markers of high membrane lipid remodeling and antioxidant capacity in Y-RCCs, whereas O-RCCs had increased markers of oxidative stress and decreased coping capability. CONCLUSION The structural, functional, and metabolic dissimilarities of Y-RCCs and O-RCCs from female and male donors demonstrate RCC heterogeneity, where RBCs from females contribute less to the storage lesion and age slower than males.
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Affiliation(s)
- Olga Mykhailova
- Centre for Innovation, Canadian Blood Services, Edmonton, Alberta, Canada
| | - Carly Olafson
- Centre for Innovation, Canadian Blood Services, Edmonton, Alberta, Canada
| | - Tracey R Turner
- Centre for Innovation, Canadian Blood Services, Edmonton, Alberta, Canada
| | - Angelo DʼAlessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jason P Acker
- Centre for Innovation, Canadian Blood Services, Edmonton, Alberta, Canada.,Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
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14
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Aurich K, Fregin B, Palankar R, Wesche J, Hartwich O, Biedenweg D, Nguyen TH, Greinacher A, Otto O. Label-free on chip quality assessment of cellular blood products using real-time deformability cytometry. LAB ON A CHIP 2020; 20:2306-2316. [PMID: 32458864 DOI: 10.1039/d0lc00258e] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Without cellular blood products such as platelet concentrates (PC), red blood cell concentrates (RCC), and hematopoietic stem cells (HPSC) modern treatments in medicine would not be possible. An unresolved challenge is the assessment of their quality with minimal cell manipulation. Minor changes in production, storage conditions, or blood bag composition may impact cell function, which can have important consequences on product integrity. This is especially relevant for personalized medicine, such as autologous T-cell therapy. Today a robust methodology that globally determines cell status directly before transfusion or transplantation is lacking. We demonstrate that measuring viscoelastic characteristics of peripheral blood cells using real-time deformability cytometry (RT-DC) provides comprehensive information on product quality, which is not accessible using conventional quality control tests. In addition, RT-DC requires few cells, a minimal sample volume and has a rapid turnaround time. We compared RT-DC to standard in vitro quality assays assessing: i) PC after storage at 4 °C and room temperature; ii) magnetic nanoparticle labeled platelets; iii) RCC stored in blood bags with different plasticizers; iv) RCC after gamma irradiation; and v) HPSC after cryopreservation with 5% or 10% dimethyl sulfoxide, respectively. Additionally, we evaluated the engraftment time of patients' platelets and leukocytes after transplantation of HPSC products. Our results demonstrate that label-free mechano-phenotyping can be used as a potential biomarker for quality assessment of cell-based pharmaceutical products.
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Affiliation(s)
- Konstanze Aurich
- Transfusionsmedizin, Universitätsmedizin Greifswald, 17475 Greifswald, Germany.
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15
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Chu Z, Wang Y, You G, Wang Q, Ma N, Li B, Zhao L, Zhou H. The P50 value detected by the oxygenation-dissociation analyser and blood gas analyser. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2020; 48:867-874. [DOI: 10.1080/21691401.2020.1770272] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Zongtang Chu
- Institute of Health Service and Transfusion Medicine, Academy of Military Medical Sciences, Academy of Military Science of the Chinese People’s Liberation Army, Beijing, P.R. China
| | - Ying Wang
- Institute of Health Service and Transfusion Medicine, Academy of Military Medical Sciences, Academy of Military Science of the Chinese People’s Liberation Army, Beijing, P.R. China
| | - Guoxing You
- Institute of Health Service and Transfusion Medicine, Academy of Military Medical Sciences, Academy of Military Science of the Chinese People’s Liberation Army, Beijing, P.R. China
| | - Quan Wang
- Institute of Health Service and Transfusion Medicine, Academy of Military Medical Sciences, Academy of Military Science of the Chinese People’s Liberation Army, Beijing, P.R. China
| | - Ning Ma
- Institute of Health Service and Transfusion Medicine, Academy of Military Medical Sciences, Academy of Military Science of the Chinese People’s Liberation Army, Beijing, P.R. China
| | - Bingting Li
- Institute of Health Service and Transfusion Medicine, Academy of Military Medical Sciences, Academy of Military Science of the Chinese People’s Liberation Army, Beijing, P.R. China
| | - Lian Zhao
- Institute of Health Service and Transfusion Medicine, Academy of Military Medical Sciences, Academy of Military Science of the Chinese People’s Liberation Army, Beijing, P.R. China
| | - Hong Zhou
- Institute of Health Service and Transfusion Medicine, Academy of Military Medical Sciences, Academy of Military Science of the Chinese People’s Liberation Army, Beijing, P.R. China
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16
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Yasui K, Matsuyama N, Takihara Y, Hirayama F. New insights into allergic transfusion reactions and their causal relationships, pathogenesis, and prevention. Transfusion 2020; 60:1590-1601. [DOI: 10.1111/trf.15845] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/22/2020] [Accepted: 04/08/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Kazuta Yasui
- Japanese Red Cross Kinki Block Blood Center Ibaraki Osaka Japan
| | | | | | - Fumiya Hirayama
- Japanese Red Cross Kinki Block Blood Center Ibaraki Osaka Japan
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17
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Chun S, Phan MTT, Hong S, Yang J, Yoon Y, Han S, Kang J, Yazer MH, Kim J, Cho D. Double-filtered leukoreduction as a method for risk reduction of transfusion-associated graft-versus-host disease. PLoS One 2020; 15:e0229724. [PMID: 32214402 PMCID: PMC7098637 DOI: 10.1371/journal.pone.0229724] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 02/13/2020] [Indexed: 11/20/2022] Open
Abstract
Background Transfusion-associated graft-versus-host disease (TA-GvHD) is caused by leukocytes, specifically T cells within a transfused blood product. Currently, the prevention of transfusion-associated graft-versus-host disease is performed by irradiation of blood products. With a sufficient reduction of leukocytes, the risk for TA-GvHD can be decreased. With consistent advances in current state-of-the-art blood filters, we herein propose that double filtration can sufficiently reduce leukocytes to reduce the risk for TA-GvHD. Materials Thirty RBC concentrates were filtered with leukocyte filters, followed by storage at 1–6 oC for 72 hours, and then a second filtration was performed. Residual leukocytes in the double-filtered RBC units (n = 30) were assessed with flow cytometric methods, and an additional assay with isolated peripheral blood mononuclear cells (PBMCs) (n = 6) was done by both flow cytometric methods and an automated hematology analyzer. Quality of the RBCs after filtration was evaluated by hematological and biochemical tests. In vitro T cell expansion was performed using anti-CD3/CD28-coated Dynabeads or anti-CD3 (OKT3). In vivo experiment for GvHD was performed by using NOD.Cg-Prkdcscid Il2rgtm1Wjl/SzJ (NSG) mice. Results Double-filtered blood products showed residual leukocyte levels below detection limits, which calculated to be below 1200–2500 cells per blood unit. In vitro expansion rate of T cells showed that 6x103 and 1x103 cell-seeded specimens showed 60.8±10.6 fold and 10.2±9.7-fold expansion, respectively. Cell expansion was not sufficiently observed in wells planted with 1x102 or 10 cells. In vivo experiments showed that mice injected with 1x105 or more cells cause fatal GvHD. GvHD induced inflammation was observed in mice injected with 1x104 or more cells. No evidence of GvHD was found in mice injected with 103 cells. Conclusions Our study suggests that additional removal of contaminating lymphocytes by a second leukodepletion step may further reduce the risk for TA-GvHD.
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Affiliation(s)
- Sejong Chun
- Department of Laboratory Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea
| | - Minh-Trang Thi Phan
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunwan University School of Medicine, Seoul, Korea
| | - Saetbyul Hong
- Animal Research and Molecular Imaging Center, Samsung Medical Center, Seoul, Korea
| | - Jehoon Yang
- Animal Research and Molecular Imaging Center, Samsung Medical Center, Seoul, Korea
| | - Yeup Yoon
- Animal Research and Molecular Imaging Center, Samsung Medical Center, Seoul, Korea
- Samsung Advanced Institute for Health Sciences & Technology, Sungkyunwan University School of Medicine, Seoul, Korea
| | - Sangbin Han
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jungwon Kang
- Blood Transfusion Research Institute, Korean Red Cross, Wonju, Korea
| | - Mark H. Yazer
- Department of Pathology, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Jaehyun Kim
- Blood Transfusion Research Institute, Korean Red Cross, Wonju, Korea
- * E-mail: (DC); (JK)
| | - Duck Cho
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunwan University School of Medicine, Seoul, Korea
- Samsung Advanced Institute for Health Sciences & Technology, Sungkyunwan University School of Medicine, Seoul, Korea
- * E-mail: (DC); (JK)
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18
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Liu J, Han Y, Hua W, Wang Y, You G, Li P, Liao F, Zhao L, Ding Y. Improved flowing behaviour and gas exchange of stored red blood cells by a compound porous structure. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2019; 47:1888-1897. [PMID: 31072140 DOI: 10.1080/21691401.2019.1614018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Storage lesions in red blood cells (RBCs) hinder efficient circulation and tissue oxygenation. The absence of flow mechanics and gas exchange may contribute to this problem. To test if in vitro compensation of flow mechanics and gas exchange helps RBC recovery, three-dimensional polydimethylsiloxane (PDMS) porous structures were fabricated with a sugar mould, simulating lung alveoli. RBC suspensions were passed through the porous structure cyclically, simulating in vivo blood circulation. Acid-base indices, partial gas pressures, ions, glucose and RBC indices were analyzed. An atomic force microscope was used to investigate local mechanical properties of intact RBCs. RBCs suspensions that passed through the porous structures had a higher pH and oxygen partial pressure, and a lower potassium concentration and carbon dioxide partial pressure. Meantime they had better biochemical properties relative to static samples, namely, they exhibited a more homogenous distribution of Young's Modulus. RBCs that passed through a PDMS porous structure were healthier than static ones, giving hints to prevent RBC storage lesions.
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Affiliation(s)
- Jing Liu
- a College of Life Sciences , University of Chinese Academy of Sciences , Beijing , P. R. China
| | - Yusu Han
- b Chinese Medical College , Tianjin University of Traditional Chinese Medicine , Tianjin , P. R. China
| | - Wenda Hua
- c National Centre for Nanoscience and Technology , Beijing , P. R. China
| | - Ying Wang
- d Institute of Health Service and Transfusion Medicine, Beijing Key Laboratory of Blood Safety and Supply Technologies , Academy of Military Medical Sciences , Beijing , P. R. China
| | - Guoxing You
- d Institute of Health Service and Transfusion Medicine, Beijing Key Laboratory of Blood Safety and Supply Technologies , Academy of Military Medical Sciences , Beijing , P. R. China
| | - Penglong Li
- d Institute of Health Service and Transfusion Medicine, Beijing Key Laboratory of Blood Safety and Supply Technologies , Academy of Military Medical Sciences , Beijing , P. R. China
| | - Fulong Liao
- c National Centre for Nanoscience and Technology , Beijing , P. R. China
| | - Lian Zhao
- d Institute of Health Service and Transfusion Medicine, Beijing Key Laboratory of Blood Safety and Supply Technologies , Academy of Military Medical Sciences , Beijing , P. R. China
| | - Yongsheng Ding
- a College of Life Sciences , University of Chinese Academy of Sciences , Beijing , P. R. China
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19
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Adams F, Bellairs GRM, Bird AR, Oguntibeju OO. Metabolic effects occurring in irradiated and non-irradiated red blood cellular components for clinical transfusion practice: An in vitro comparison. Afr J Lab Med 2018; 7:606. [PMID: 30568891 PMCID: PMC6295826 DOI: 10.4102/ajlm.v7i1.606] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 07/20/2018] [Indexed: 01/31/2023] Open
Abstract
Background Storage lesions occur in red blood cell products when potassium ions, haemoglobin and lactate dehydrogenase are released into the extracellular plasma due to post-irradiation storage or cellular degeneration. The South African blood transfusion establishments do not comply with the universal leucocyte-reduction policy due to cost and the current HIV pandemic. Various studies regarding storage lesions have been completed in well-developed countries but not in Cape Town, South Africa. Objective This study aimed to determine cellular degeneration occurring in non-irradiated and irradiated red blood cells (RBC) by comparing the measured biochemical and haematological indices during storage of up to 42 days. Method Eighty whole blood units were collected from voluntary, non-remunerated donors. Blood components tested weekly until expiry were whole blood, RBC concentrate, leucocyte-reduced RBC concentrate (pre-storage) and paediatric RBC concentrate (n = 20). Ten units per product were irradiated and 10 were not. Evaluations included potassium, sodium, glucose, lactate dehydrogenase, phosphate, haemoglobin, haematocrit, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentrate, mean cell volume and plasma haemoglobin. Plasma haemolysis levels were calculated using an approved formula. Results The haemolysis levels evaluated on Day 35 and Day 42 were higher than the recommended 0.8%, whereas results for the non-irradiated components up to expiry were all below 0.8%. Conclusion This study confirms that gamma irradiation aggravates the RBC storage lesions. The products tested yielded similar results to other studies in developed countries, however the South Africa transfusion medicine policy should remain unchanged.
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Affiliation(s)
- Faieqa Adams
- Western Province Blood Transfusion Service, Cape Town, South Africa
| | | | - Arthur R Bird
- Western Province Blood Transfusion Service, Cape Town, South Africa
| | - Oluwafemi O Oguntibeju
- Department of Biomedical Sciences, Cape Peninsula University of Technology, Cape Town, South Africa
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20
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Kwon JH, Han S, Cho D, Spahn DR, Ko JS, Kim DY, Jun JH, Gwak MS, Kim GS. Longer storage of red blood cells does not affect mortality in transfused liver transplant recipients. Transfusion 2018; 58:2529-2537. [PMID: 30298928 DOI: 10.1111/trf.14961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 07/20/2018] [Accepted: 07/21/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND The characteristics of red blood cell (RBC) products change after 2 weeks of cold storage. It is unclear whether older RBCs affect mortality after liver transplantation. This retrospective cohort study aimed to evaluate the association between the age of transfused RBCs and death after living donor liver transplantation (LDLT). STUDY DESIGN AND METHODS Of 200 recipients who underwent LDLT, 118 who received RBCs with a mean storage duration of less than 10 days (shorter storage group) were compared with 82 with an RBC mean storage duration of more than 14 days (longer storage group). Key exclusion criteria were transfusion of very fresh RBCs stored for less than 4 days and transfusion of old RBCs in recipients of the shorter storage group. The primary outcome was posttransplant overall death. Survival analysis was performed using the Cox model. RESULTS Mean RBC storage duration was 7 days in the shorter storage group and 17 days in the longer storage group. Death probability at 1, 2, and 5 years posttransplant was 5.1%, 7.6%, and 13.6% in the shorter storage group, respectively, and 6.1%, 8.5%, and 13.5% in the longer storage group. Death risk was comparable between the two groups in univariable (hazard ratio [HR] 1.00, 95% confidence interval [CI], 0.47-2.16, p = 0.991) and multivariable (HR 1.07, 95% CI, 0.46-2.50, p = 0.882) analyses. Graft failure risk was also comparable (HR 1.04, 95% CI, 0.50-2.18, p = 0.916). Hepatocellular carcinoma recurrence probability at 1, 2, and 5 years was 10.8%, 15.4%, and 23.1%, respectively, in the shorter storage group and 11.4%, 15.9%, and 20.7% in the longer storage group (HR 0.84, 95% CI, 0.37-1.89, p = 0.670). No significant differences were observed regarding graft regeneration/function, vascular/biliary complications, acute kidney injury, surgical site infection, or rejection (p > 0.05). CONCLUSIONS No evidence was found that transfusion of old RBCs contributes to death after LDLT.
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Affiliation(s)
- Ji Hye Kwon
- Department of Anesthesiology and Pain Medicine, Seoul, South Korea
| | - Sangbin Han
- Department of Anesthesiology and Pain Medicine, Seoul, South Korea
| | - Duck Cho
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Donat R Spahn
- Institute of Anesthesiology, University and University Hospital of Zürich, Zürich, Switzerland
| | - Justin S Ko
- Department of Anesthesiology and Pain Medicine, Seoul, South Korea
| | - Do Yeon Kim
- Department of Anesthesiology and Pain Medicine, Seoul, South Korea
| | - Joo Hyun Jun
- Department of Anesthesiology and Pain Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Mi Sook Gwak
- Department of Anesthesiology and Pain Medicine, Seoul, South Korea
| | - Gaab Soo Kim
- Department of Anesthesiology and Pain Medicine, Seoul, South Korea
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Fullerenol C60(OH)36 protects human erythrocyte membrane against high-energy electrons. BIOCHIMICA ET BIOPHYSICA ACTA-BIOMEMBRANES 2018; 1860:1528-1536. [DOI: 10.1016/j.bbamem.2018.05.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 05/14/2018] [Accepted: 05/14/2018] [Indexed: 12/29/2022]
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22
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Red blood cells metabolome changes upon treatment with different X-ray irradiation doses. Ann Hematol 2018; 97:1909-1917. [DOI: 10.1007/s00277-018-3386-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 05/27/2018] [Indexed: 12/22/2022]
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23
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Jani VP, Yalcin O, Williams AT, Popovsky MA, Cabrales P. Rat red blood cell storage lesions in various additive solutions. Clin Hemorheol Microcirc 2018; 67:45-57. [PMID: 28598831 DOI: 10.3233/ch-170248] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Small rodent models are routinely used to evaluate the safety and efficacy of blood transfusions. Limited comprehensive literature exists about effect of different storage solutions in rat red blood cells (RBCs) characteristics. RBCs undergo time dependent biochemical and biophysical changes during storage known as hypothermic storage lesions (HSLs). OBJECTIVE This study evaluates the effects of RBC additive solutions (AS) during storage of rat RBCs. METHODS Blood was leukoreduced and stored as per manufacturer instructions at 4°C up to 42-days. Three solutions, CPDA-1; AS-1; and AS-7 (SOLX), were evaluated. Biochemical parameters measured included extracellular K+, pH, hemolysis, 2,3-diphosphoglycerate (2,3-DPG), oxygen affinity, ATP, and lactate. Mechanical properties measured included RBC deformability, elongation index (EI), RBC membrane shear elastic modulus (SEM), mean corpuscular volume (MCV), viscosity, and aggregability. RESULTS There were no differences in biochemical or mechanical parameters at baseline or after one week of storage. However, after two weeks, AS-7 preserved biochemical and mechanical properties as compared to CPDA-1 and AS-1. Changes were observed to be significant after 14-days of storage. AS-7 prevented extracellular K+ increase, reduced acidosis, showed lower hemolysis, preserved ATP and 2,3-DPG levels (consequently oxygen affinity), and reduced lactate. AS-7, when compared to CPDA-1 and AS-1, prevented the reduction in RBC deformability and was found to preserve the EI at multiple shear stresses, the membrane SEM, the aggregability and viscosity. DISCUSSION Rat RBCs stored with AS-7 presented reduced changes in biochemical and mechanical parameters, when compared with rat RBCs stored in CPDA-1 and AS-1, after as early as two weeks of storage.
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Affiliation(s)
- Vivek P Jani
- Department of Bioengineering, University of California, San Diego, CA, USA
| | - Ozlem Yalcin
- Department of Bioengineering, University of California, San Diego, CA, USA.,School of Medicine, Koç University, Sariyer, Istanbul, Turkey
| | | | | | - Pedro Cabrales
- Department of Bioengineering, University of California, San Diego, CA, USA
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24
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Acosta-Elías MA, Burgara-Estrella AJ, Sarabia-Sainz JAI, Silva-Campa E, Angulo-Molina A, Santacruz-Gómez KJ, Castaneda B, Soto-Puebla D, Ledesma-Osuna AI, Melendrez-Amavizca R, Pedroza-Montero M. Nano alterations of membrane structure on both γ-irradiated and stored human erythrocytes. Int J Radiat Biol 2017; 93:1306-1311. [DOI: 10.1080/09553002.2017.1393581] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
| | | | | | - Erika Silva-Campa
- Departamento de Investigación en Física, Universidad de Sonora, Hermosillo, México
| | - Aracely Angulo-Molina
- Departamento de Ciencias Químico Biológicas, Universidad de Sonora, Hermosillo, México
| | | | | | - Diego Soto-Puebla
- Departamento de Investigación en Física, Universidad de Sonora, Hermosillo, México
| | - Ana Irene Ledesma-Osuna
- Departamento de Investigación y Posgrado en Alimentos, Universidad de Sonora, Hermosillo, México
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25
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Wilson CR, Pashmakova MB, Heinz JA, Johnson MC, Minard HM, Bishop MA, Barr JW. Biochemical evaluation of storage lesion in canine packed erythrocytes. J Small Anim Pract 2017; 58:678-684. [PMID: 28741656 DOI: 10.1111/jsap.12713] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 11/21/2016] [Accepted: 05/26/2017] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To describe the biochemical changes - also known as the storage lesion - that occur in canine packed red blood cells during ex vivo storage. MATERIALS AND METHODS Ten 125-mL units of non-leuco-reduced packed red blood cells in citrate phosphate dextrose adenine were obtained from a commercial blood bank within 24 hours of donation. Samples were aseptically collected on days 1, 4, 7, 14, 28, 35 and 42 for measurement of sodium, potassium, chloride, lactate, glucose, pH and ammonia concentrations. All units were cultured on day 42. Friedman's repeated measures test with Dunn's multiple comparison test was used for non-parametric data. A repeated-measures analysis of variance with Tukey's multiple comparison test was used for parametric data. Alpha was set to 0·05. RESULTS All analytes changed significantly during storage. The mean ammonia on day 1 (58·14 g/dL) was significantly lower (P<0·05) than those on days 28 (1266 g/dL), 35 (1668 g/dL) and 42 (1860 g/dL). A significant increase in median lactate concentration over time was also observed, with day 1 (4·385 mmol/L) being significantly less (P<0·05) than days 14 (19·82 mmol/L), 21 (22·81 mmol/L), 35 (20·31 mmol/L) and 42 (20·81 mmol/L). Median pH was significantly decreased after day 7. All bacterial cultures were negative. CLINICAL SIGNIFICANCE Many biochemical alterations occur in stored canine packed red blood cells, although further studies are required to determine their clinical importance.
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Affiliation(s)
- C R Wilson
- Department of Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, Texas, 77845, USA
| | - M B Pashmakova
- Department of Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, Texas, 77845, USA
| | - J A Heinz
- Department of Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, Texas, 77845, USA
| | - M C Johnson
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Texas A&M University, College Station, Texas, 77845, USA
| | - H M Minard
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Texas A&M University, College Station, Texas, 77845, USA
| | - M A Bishop
- The Animal Specialty Hospital of Florida, Naples, Florida, 34112, USA
| | - J W Barr
- Department of Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, Texas, 77845, USA
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26
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Garraud O, Tariket S, Sut C, Haddad A, Aloui C, Chakroun T, Laradi S, Cognasse F. Transfusion as an Inflammation Hit: Knowns and Unknowns. Front Immunol 2016; 7:534. [PMID: 27965664 PMCID: PMC5126107 DOI: 10.3389/fimmu.2016.00534] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 11/11/2016] [Indexed: 01/15/2023] Open
Abstract
Transfusion of blood cell components is frequent in the therapeutic arsenal; it is globally safe or even very safe. At present, residual clinical manifestations are principally inflammatory in nature. If some rare clinical hazards manifest as acute inflammation symptoms of various origin, most of them linked with conflicting and undesirable biological material accompanying the therapeutic component (infectious pathogen, pathogenic antibody, unwanted antigen, or allergen), the general feature is subtler and less visible, and essentially consists of alloimmunization or febrile non-hemolytic transfusion reaction. The present essay aims to present updates in hematology and immunology that help understand how, when, and why subclinical inflammation underlies alloimmunization and circumstances characteristic of red blood cells and – even more frequently – platelets that contribute inflammatory mediators. Modern transfusion medicine makes sustained efforts to limit such inflammatory hazards; efforts can be successful only if one has a clear view of each element’s role.
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Affiliation(s)
- Olivier Garraud
- Faculty of Medicine of Saint-Etienne, University of Lyon, Saint-Etienne, France; Institut National de la Transfusion Sanguine, Paris, France
| | - S Tariket
- Faculty of Medicine of Saint-Etienne, University of Lyon , Saint-Etienne , France
| | - C Sut
- Faculty of Medicine of Saint-Etienne, University of Lyon , Saint-Etienne , France
| | - A Haddad
- Faculty of Medicine of Saint-Etienne, University of Lyon, Saint-Etienne, France; Hôpital du Sacré-Coeur, Beirut, Lebanon
| | - C Aloui
- Faculty of Medicine of Saint-Etienne, University of Lyon , Saint-Etienne , France
| | - T Chakroun
- Faculty of Medicine of Saint-Etienne, University of Lyon, Saint-Etienne, France; Centre de Transfusion Sanguine, Sousse, Tunisia; Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
| | - S Laradi
- Faculty of Medicine of Saint-Etienne, University of Lyon, Saint-Etienne, France; Etablissement Français du Sang Rhône-Alpes-Auvergne, Saint-Etienne, France
| | - F Cognasse
- Faculty of Medicine of Saint-Etienne, University of Lyon, Saint-Etienne, France; Etablissement Français du Sang Rhône-Alpes-Auvergne, Saint-Etienne, France
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27
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Hunsicker O, Krannich A, Spies C, Feldheiser A. Association of Sodium Homeostasis with Blood Transfusions During Liver Transplantation. Anesth Analg 2016; 122:916-917. [DOI: 10.1213/ane.0000000000001057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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28
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AlZahrani K, Al-Sewaidan HA. Nanostructural Changes in the Cell Membrane of Gamma-Irradiated Red Blood Cells. Indian J Hematol Blood Transfus 2016; 33:109-115. [PMID: 28194066 DOI: 10.1007/s12288-016-0657-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 02/03/2016] [Indexed: 11/30/2022] Open
Abstract
The effect of gamma radiation on the ultrastructure of the cell membranes of red blood cells has been probed using a powerful tool, namely, atomic force microscopy. We used mice erythrocytes as a model. Blood samples withdrawn from mice were gamma-irradiated using a 60Co source unit with doses of 10,15,20,25 and 30 Gy. Structural changes appeared in the form of nanoscale potholes, depressions and alterations of the cell membrane roughness. The roughness of the cell membrane increased dramatically with increasing doses, although at 10 Gy , the cell membrane roughness was less than that of normal red blood cells (controls). Therefore, such modifications at the nano-scale level may affect the biophysical properties of membranes, resulting in impairment of their function.
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Affiliation(s)
- Khalid AlZahrani
- Physics Department, King Saud University, P.O. Box 2455, Riyadh, 11451 Kingdom of Saudi Arabia.,King Abdullah Institute for Nanotechnology, King Saud University, P.O. Box 2455, Riyadh, 11451 Kingdom of Saudi Arabia
| | - Hamed A Al-Sewaidan
- Physics Department, King Saud University, P.O. Box 2455, Riyadh, 11451 Kingdom of Saudi Arabia
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