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Schossee N, Veit G, Gittel J, Viebahn J, Niklaus M, Klingler P, Üçeyler N, Klinker E, Kobsar A, Boeck M, Koessler J. Profile of the single-use, multiple-pass protein A adsorber column in immunoadsorption. Vox Sang 2021; 117:393-398. [PMID: 34545576 DOI: 10.1111/vox.13205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/25/2021] [Accepted: 08/31/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Immunoadsorptions (IA) are used to remove autoantibodies from the plasma in autoimmune disorders. In this study, we evaluated the effects of a single-use, recombinant staphylococcal protein A-based immunoadsorber on blood composition of the patient. MATERIALS AND METHODS In a cohort of patients with myasthenia gravis or stiff-person syndrome, essential parameters of blood cell count, coagulation, clinical chemistry or plasma proteins and immunoglobulins (Ig) were measured before and after IA (n = 11). RESULTS In average, IA reduced the levels of total IgG, IgG1, IgG2 and IgG4 by approximately 60%, the acetylcholine receptor autoantibody levels by more than 70%. IgG3, IgA or IgM were diminished to a lower extent. In contrast to fibrinogen or other coagulation factors, the column markedly removed vitamin K-dependent coagulation factors II, VII, IX and X by approximately 40%-70%. Accordingly, international normalized ratio and activated partial thromboplastin time were increased after IA by 59.1% and 32.7%, respectively. Coagulation tests almost returned to baseline values within 24 h. Blood cell count, electrolytes, total protein or albumin were not essentially affected. No clinical events occurred. CONCLUSION The single-use, multiple-pass protein A adsorber column is highly efficient to remove IgG1, IgG2 and IgG4 or specific acetylcholine receptor autoantibodies from the plasma. Coagulation parameters should be monitored, since the column has the capacity to largely reduce vitamin K-dependent factors.
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Affiliation(s)
- Nadine Schossee
- Institute of Transfusion Medicine and Haemotherapy, University of Wuerzburg, Wuerzburg, Germany
| | - Gabriele Veit
- Institute of Transfusion Medicine and Haemotherapy, University of Wuerzburg, Wuerzburg, Germany
| | - Julia Gittel
- Institute of Transfusion Medicine and Haemotherapy, University of Wuerzburg, Wuerzburg, Germany
| | - Johannes Viebahn
- Institute of Transfusion Medicine and Haemotherapy, University of Wuerzburg, Wuerzburg, Germany
| | - Marius Niklaus
- Institute of Transfusion Medicine and Haemotherapy, University of Wuerzburg, Wuerzburg, Germany
| | - Philipp Klingler
- Institute of Transfusion Medicine and Haemotherapy, University of Wuerzburg, Wuerzburg, Germany
| | - Nurcan Üçeyler
- Department of Neurology, University of Wuerzburg, Wuerzburg, Germany
| | - Erdwine Klinker
- Institute of Transfusion Medicine and Haemotherapy, University of Wuerzburg, Wuerzburg, Germany
| | - Anna Kobsar
- Institute of Transfusion Medicine and Haemotherapy, University of Wuerzburg, Wuerzburg, Germany
| | - Markus Boeck
- Institute of Transfusion Medicine and Haemotherapy, University of Wuerzburg, Wuerzburg, Germany
| | - Juergen Koessler
- Institute of Transfusion Medicine and Haemotherapy, University of Wuerzburg, Wuerzburg, Germany
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Polinski KJ, Armstrong M, Manke J, Seifert J, Crume T, Yang F, Clare-Salzler M, Holers VM, Reisdorph N, Norris JM. Collection and Storage of Human Plasma for Measurement of Oxylipins. Metabolites 2021; 11:137. [PMID: 33652624 DOI: 10.3390/metabo11030137] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/15/2021] [Accepted: 02/23/2021] [Indexed: 12/31/2022] Open
Abstract
Oxylipins derived from omega-3 and -6 fatty acids are actively involved in inflammatory and immune processes and play important roles in human disease. However, as the interest in oxylipins increases, questions remain regarding which molecules are detectable in plasma, the best methods of collecting samples, and if molecules are stable during collection and storage. We thereby built upon existing studies by examining the stability of an expanded panel of 90 oxylipins, including specialized pro-resolving lipid mediators (SPMs), in human plasma (n = 5 subjects) during sample collection, processing, and storage at −80 °C. Oxylipins were quantified using liquid chromatography-tandem mass spectrometry (LC/MS/MS). Blood samples collected in ethylenediaminetetraacetic acid (EDTA) or heparin followed by up to 2 h at room temperature prior to processing showed no significant differences in oxylipin concentrations compared to immediately processed samples, including the SPMs lipoxin A4 and resolvin D1. The majority of molecules, including SPMs, remained stable following storage for up to 1 year. However, in support of previous findings, changes were seen in a small subset of oxylipins including 12-HETE, TXB2, 14-HDHA, and 18-HEPE. Overall, this study showed that accurate measurements of most oxylipins can be obtained from stored EDTA or heparin plasma samples using LC/MS/MS.
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Bardyn M, Martin A, Dögnitz N, Abonnenc M, Dunham A, Yoshida T, Prudent M. Oxygen in Red Blood Cell Concentrates: Influence of Donors' Characteristics and Blood Processing. Front Physiol 2021; 11:616457. [PMID: 33424640 PMCID: PMC7786264 DOI: 10.3389/fphys.2020.616457] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 11/30/2020] [Indexed: 12/28/2022] Open
Abstract
Objective: Unexpectedly wide distribution (<10 to >90%) of hemoglobin oxygen saturation (sO2) within red cell concentrates (RCCs) has recently been observed. Causes of such variability are not yet completely explained whereas the roles of oxygen and oxidative lesions during the storage of RCCs are known. The objectives of the present study are to characterize sO2 distribution in RCCs produced in a Swiss blood center and to investigate the influence of processing and donors’ characteristics. Methods: The level of sO2 was measured in 1701 leukocyte-depleted RCCs derived from whole blood donations in both top–bottom (TB; component filtered, SAGM) and top–top (TT; whole blood filtration, PAGGSM) RCCs. The sO2 value was measured non-invasively through the PVC bag prior to storage by resonance Raman spectroscopy. Gender, age, blood type, hemoglobin level, and living altitude of donors, as well as process method and time-to-process were recorded. Results: Overall, the sO2 exhibited a wide non-Gaussian distribution with a mean of 51.2 ± 18.5%. Use of top-top kits resulted in a 16% higher sO2 (P < 0.0001) than with top-bottom ones. Waiting time before processing only had a modest impact, but the blood processing itself reduced the sO2 by almost 12% (P < 0.0001). sO2 was also significantly affected by some donors’ characteristics. RCCs from men exhibited 25% higher sO2 (P < 0.0001) than those donated by women. Multivariate analysis revealed that the apparent correlation observed with hemoglobin level and age was actually due to multicollinearity with the sex variable. Finally, we noticed no significant differences across blood type but found that altitude of residence was associated with the sO2 (i.e., higher in higher living place). Conclusion: These data confirm wide sO2 distribution in RCCs reported recently. The sO2 was impacted by the processing and also by donors’ characteristics such as the gender and the living altitude, but not by the hemoglobin level, blood group and donor age. This study provides new hints on the factors influencing red blood cells storage lesions, since they are known to be related to O2 content within the bags, giving clues to better process and to better store RCCs and therefore potentially improve the efficacy of transfusion.
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Affiliation(s)
- Manon Bardyn
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - Agathe Martin
- Laboratoire de Préparation Cellulaire et d'Analyses, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - Nora Dögnitz
- Département Approvisionnement Produits Sanguins, Transfusion Interrégionale CRS, Bern, Switzerland
| | - Mélanie Abonnenc
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland.,Laboratoire de Préparation Cellulaire et d'Analyses, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | | | | | - Michel Prudent
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland.,Centre de Transfusion Sanguine, Faculté de Biologie et de Médecine, Université de Lausanne, Lausanne, Switzerland
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Kumukova I, Trakhtman P, Starostin N, Borsakova D, Ignatova A, Bayzyanova Y. Quality assessment of red blood cell suspensions derived from pathogen-reduced whole blood. Vox Sang 2020; 116:547-556. [PMID: 33222171 DOI: 10.1111/vox.13039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND We used laboratory indicators to evaluate the quality of pathogen-reduced red blood cell suspension (RBCS) compared with gamma-irradiated RBCS. MATERIALS AND METHODS To determine biochemical and metabolic parameters of RBCS, we obtained 50 whole blood units from healthy volunteers and randomized them into 2 groups: 25 were pathogen-reduced, and then, RBCS prepared from them. RBCS from the other 25 was gamma-irradiated. Sampling was carried out on day zero before and after treatment and at 7, 14, 21 and 28 days. To determine lymphocyte inactivation, we collected another 35 whole blood units. Each was sampled to form 3 study groups: untreated, gamma-irradiated and pathogen-reduced. Daily sampling was carried out during 3 days of storage. RESULTS The quality of RBCS from both groups was largely the same, except for haemolysis and red blood cell fragility, which were more pronounced in the pathogen-reduced group. This finding limited the shelf life of pathogen-reduced RBCS to 14 days. Lymphocyte viability was significantly reduced after both treatments. Proliferation of lymphocytes after pathogen reduction was reduced to the detection limit, while low-level proliferation was observed in gamma-irradiated samples. CONCLUSION Pathogen-reduced red blood cells have acceptable quality and can be used for transfusion within 14 days. Results of inactivation of lymphocytes demonstrate that pathogen reduction technology, applied on WB, can serve as an alternative to irradiation.
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Affiliation(s)
- Irina Kumukova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology Oncology and Immunology, Moscow, Russia
| | - Pavel Trakhtman
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology Oncology and Immunology, Moscow, Russia
| | - Nicolay Starostin
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology Oncology and Immunology, Moscow, Russia
| | - Daria Borsakova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology Oncology and Immunology, Moscow, Russia.,Laboratory of Physiology and Biophysics of the Cell, Center for Theoretical Problems of Physicochemical Pharmacology, Russian Academy of Sciences, Moscow, Russia
| | - Anastasia Ignatova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology Oncology and Immunology, Moscow, Russia
| | - Yana Bayzyanova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology Oncology and Immunology, Moscow, Russia
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Sanderson VP, Mainprize IL, Verzijlenberg L, Khursigara CM, Wills MKB. The Platelet Fraction Is a Novel Reservoir to Detect Lyme Borrelia in Blood. Biology (Basel) 2020; 9:biology9110366. [PMID: 33137967 PMCID: PMC7694117 DOI: 10.3390/biology9110366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 11/23/2022]
Abstract
Simple Summary To diagnose Lyme disease, a patient’s blood is tested for antibodies that develop as part of the immune response. This can lead to cases being missed or inadequately treated. An ideal test would directly detect the Lyme disease bacteria, Borrelia, to provide better clinical guidance. In this study, we aimed to improve the methods currently used to find Borrelia in human blood, and identified two opportunities for optimization. We demonstrate that the container most commonly used to collect blood (EDTA) decreases Borrelia’s ability to grow, and we identify a superior alternative (citrate). Additionally, using experimentally infected blood, we show that Borrelia is highly concentrated in the platelet fraction, making it an ideal candidate for direct detection. These results lay the foundation for diagnostic test development, which could improve patient outcomes in Lyme disease. Abstract Serological diagnosis of Lyme disease suffers from considerable limitations. Yet, the technique cannot currently be replaced by direct detection methods, such as bacterial culture or molecular analysis, due to their inadequate sensitivity. The low bacterial burden in vasculature and lack of consensus around blood-based isolation of the causative pathogen, Borrelia burgdorferi, are central to this challenge. We therefore addressed methodological optimization of Borrelia recovery from blood, first by analyzing existing protocols, and then by using experimentally infected human blood to identify the processing conditions and fractions that increase Borrelia yield. In this proof-of-concept study, we now report two opportunities to improve recovery and detection of Borrelia from clinical samples. To enhance pathogen viability and cultivability during whole blood collection, citrate anticoagulant is superior to more commonly used EDTA. Despite the widespread reliance on serum and plasma as analytes, we found that the platelet fraction of blood concentrates Borrelia, providing an enriched resource for direct pathogen detection by microscopy, laboratory culture, Western blot, and PCR. The potential for platelets to serve as a reservoir for Borrelia and its diagnostic targets may transform direct clinical detection of this pathogen.
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Affiliation(s)
- Victoria P. Sanderson
- G. Magnotta Lyme Disease Research Lab, Molecular and Cellular Biology, University of Guelph, Guelph, ON N1G 2W1, Canada; (V.P.S.); (I.L.M.); (L.V.)
| | - Iain L. Mainprize
- G. Magnotta Lyme Disease Research Lab, Molecular and Cellular Biology, University of Guelph, Guelph, ON N1G 2W1, Canada; (V.P.S.); (I.L.M.); (L.V.)
| | - Lisette Verzijlenberg
- G. Magnotta Lyme Disease Research Lab, Molecular and Cellular Biology, University of Guelph, Guelph, ON N1G 2W1, Canada; (V.P.S.); (I.L.M.); (L.V.)
| | - Cezar M. Khursigara
- Molecular and Cellular Biology, University of Guelph, Guelph, ON N1G 2W1, Canada;
| | - Melanie K. B. Wills
- G. Magnotta Lyme Disease Research Lab, Molecular and Cellular Biology, University of Guelph, Guelph, ON N1G 2W1, Canada; (V.P.S.); (I.L.M.); (L.V.)
- Correspondence: ; Tel.: +1-519-824-4120 (ext. 54062); Fax: +1-519-837-1802
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6
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Park H, Gladstone M, Shanley C, Goodrich R, Guth A. A novel cancer immunotherapy utilizing autologous tumour tissue. Vox Sang 2020; 115:525-535. [PMID: 32378223 PMCID: PMC8344074 DOI: 10.1111/vox.12935] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/18/2020] [Accepted: 04/14/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND With the recent interest in personalized medicine for cancer patients and immune therapy, the field of cancer vaccines has been resurrected. Previous autologous, whole cell tumour vaccine trials have not produced convincing results due, in part to poor patient selection and inactivation methos that are harsh on the cells. These methods can alter protein structure and antigenic profiles making vaccine candidates ineffective in stimulating immune response to autochthonous tumour cells. MATERIALS AND METHODS We investigated a novel method for inactivating tumour cells that uses UVA/UVB light and riboflavin (vitamin B2) (RF + UV). RF + UV inactivates the tumour cells' ability to replicate, yet preserves tumour cell integrity and antigenicity. RESULTS Our results demonstrate that proteins are preserved on the surface of RF + UV-inactivated tumour cells and that they are immunogenic via induction of dendritic cell maturation, increase in IFNγ production and generation of tumour cell-specific IgG. Moreover, when formulated with an adjuvant ('Innocell vaccine') and tested in different murine tumour primary and metastatic disease models, decreased tumour growth, decreased metastatic disease and prolonged survival were observed. In addition, immune cells obtained from tumour tissue following vaccination had decreased exhausted and regulatory T cells, suggesting that activation of intra-tumoural T cells may be playing a role leading to reduced tumour growth. CONCLUSIONS These data suggest that the RF + UV inactivation of tumour cells may provide an efficacious method for generating autologous whole tumour cell vaccines for use in cancer patients.
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Affiliation(s)
- Haemin Park
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA
| | | | - Crystal Shanley
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Raymond Goodrich
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Amanda Guth
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
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7
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Hult A, Toss F, Malm C, Oldenborg PA. In vitro phagocytosis of liquid-stored red blood cells requires serum and can be inhibited with fucoidan and dextran sulphate. Vox Sang 2020; 115:647-654. [PMID: 32350880 DOI: 10.1111/vox.12922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 03/03/2020] [Accepted: 03/26/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND OBJECTIVES Red-blood-cells (RBCs) undergo structural and metabolic changes with prolonged storage, which ultimately may decrease their survival after transfusion. Although the storage-induced damage to RBCs has been rather well described biochemically, little is known about the mechanisms underlying the recognition and rapid clearance of the damaged cells by macrophages. MATERIALS AND METHODS We, here, used a murine model for cold (+4°C) RBC storage and transfusion. Phagocytosis of human or murine RBCs, liquid stored for 6-8 weeks or 10-14 days, respectively, was investigated in murine peritoneal macrophages. RESULTS The effects of storage on murine RBCs resembled that described for stored human RBCs with regard to decreased adenosine triphosphate (ATP) levels, accumulation of microparticles (MPs) during storage, and RBC recovery kinetics after transfusion. Under serum-free conditions, phagocytosis of stored human or murine RBCs in vitro was reduced by 70-75%, as compared with that in the presence of heat-inactivated fetal calf serum (FCS). Human serum promoted phagocytosis of stored human RBCs similar to that seen with FCS. By adding fucoidan or dextran sulphate (blockers of scavenger receptors class A (SR-A)), phagocytosis of human or murine RBCs was reduced by more than 90%. Phagocytosis of stored human RBCs was also sensitive to inhibition by the phosphatidylinositol 3 kinase-inhibitor LY294002, the ERK1/2-inhibitor PD98059, or the p38 MAPK-inhibitor SB203580. CONCLUSION RBCs damaged during liquid storage may be recognized by macrophage SR-A and serum-dependent mechanisms. This species-independent recognition mechanism may help to further understand the rapid clearance of stored RBCs shortly after transfusion.
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Affiliation(s)
- Andreas Hult
- Section for Sports Medicine, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Fredrik Toss
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden.,Division of Clinical Immunology, Department of Clinical Microbiology, Umeå University, Umeå, Sweden
| | - Christer Malm
- Section for Sports Medicine, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Per-Arne Oldenborg
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
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8
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Wirtz MR, Almizraq RJ, Weber NC, Norris PJ, Pandey S, Spinella PC, Muszynski JA, P Acker J, Juffermans NP. Red-blood-cell manufacturing methods and storage solutions differentially induce pulmonary cell activation. Vox Sang 2020; 115:395-404. [PMID: 32166810 PMCID: PMC7497002 DOI: 10.1111/vox.12911] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 02/07/2020] [Accepted: 02/23/2020] [Indexed: 12/16/2022]
Abstract
Background and Objectives Red‐blood‐cell (RBC) transfusion is associated with lung injury, which is further exacerbated by mechanical ventilation. Manufacturing methods of blood products differ globally and may play a role in the induction of pulmonary cell activation through alteration of the immunomodulatory property of the products. Here, the effect of different manufacturing methods on pulmonary cell activation was investigated in an in vitro model of mechanical ventilation. Materials and Methods Pulmonary type II cells were incubated with supernatant from fresh and old RBC products obtained via whole blood filtration (WBF), red cell filtration (RCF), apheresis‐derived (AD) or whole blood‐derived (WBD) methods. Lung cells were subjected to 25% stretch for 24 h. Controls were non‐stretched or non‐incubated cells. Results Fresh but not old AD products and WBF products induce lung cell production of pro‐inflammatory cytokines and chemokines, which was not observed with WBD or RCF products. Effects were associated with an increased amount of platelet‐derived vesicles and an increased thrombin‐generating capacity. Mechanical stretching of lung cells induced more severe cell injury compared to un‐stretched controls, including alterations in the cytoskeleton, which was further augmented by incubation with AD products. In all read‐out parameters, RCF products seemed to induce less injury compared to the other products. Conclusions Our findings show that manufacturing methods of RBC products impact pulmonary cell activation, which may be mediated by the generation of vesicles in the product. We suggest RBC manufacturing method may be an important factor in understanding the association between RBC transfusion and lung injury.
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Affiliation(s)
- Mathijs R Wirtz
- Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Ruqayyah J Almizraq
- Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - Nina C Weber
- Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Philip J Norris
- Blood Systems Research Institute, San Francisco, CA, USA.,Departments of Laboratory Medicine and Medicine, University of California, San Francisco, CA, USA
| | - Suchitra Pandey
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA.,Blood Centers of the Pacific (member of Blood Systems), San Francisco, CA, USA
| | - Philip C Spinella
- Department of Pediatrics, Division of Critical Care, Washington University in St Louis, St Louis, MO, USA
| | - Jennifer A Muszynski
- Department of Pediatrics, Division of Critical Care Medicine, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jason P Acker
- Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada.,Centre for Innovation, Canadian Blood Services, Edmonton, AB, Canada
| | - Nicole P Juffermans
- Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
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Shih AW, Apelseth TO, Cardigan R, Marks DC, Bégué S, Greinacher A, de Korte D, Seltsam A, Shaz BH, Wikman A, Barty RL, Heddle NM, Acker JP. Not all red cell concentrate units are equivalent: international survey of processing and in vitro quality data. Vox Sang 2019; 114:783-794. [PMID: 31637738 DOI: 10.1111/vox.12836] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/03/2019] [Accepted: 07/15/2019] [Indexed: 01/08/2023]
Abstract
INTRODUCTION In vitro qualitative differences exist in red cell concentrates (RCCs) units processed from whole blood (WB) depending on the method of processing. Minimal literature exists on differences in processing and variability in quality data. Therefore, we collected information from blood manufacturers worldwide regarding (1) details of WB collection and processing used to produce RCCs and (2) quality parameters and testing as part of routine quality programmes. METHODS A secure web-based survey was developed, refined after pilot data collection and distributed to blood centres. Descriptive analyses were performed. RESULTS Data from ten blood centres in nine countries were collected. Six blood centres (60%) processed RCCs using the top-and-top (TAT) method which produces RCCs and plasma, and eight centres (80%) used the bottom-and-top (BAT) which additionally produces buffy coat platelets. Five of the centres used both processing methods; however, four favoured BAT processing. One centre utilized the Reveos automated system exclusively. All centres performed pre-storage leucoreduction. Other parameters demonstrated variability, including active cooling at collection, length of hold before processing, donor haemoglobin limits, acceptable collection weights, collection sets, time to leucoreduction, centrifugation speeds, extraction devices and maximum RCC shelf life. Quality marker testing also differed amongst blood centres. Trends towards higher RCC unit volume, haemolysis and residual leucoctyes were seen in the TAT compared with BAT processing across centres. CONCLUSION Methods and parameters of WB processing and quality testing of RCCs differ amongst surveyed blood manufacturers. Further studies are needed to assess variations and to potentially improve methods and product quality.
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Affiliation(s)
- Andrew W Shih
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Vancouver Coastal Health Authority, Vancouver, BC, Canada
| | - Torunn Oveland Apelseth
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Rebecca Cardigan
- National Health Service Blood and Transplant, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
| | - Denese C Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - Stéphane Bégué
- Établissement Français du Sang, La-Plaine-Saint-Denis, France
| | - Andreas Greinacher
- Department of Transfusion Medicine, University Medical Center Greifswald, Greifswald, Germany
| | | | | | - Beth H Shaz
- New York Blood Center, New York City, NY, USA
| | - Agneta Wikman
- Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden
| | - Rebecca L Barty
- McMaster Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada
| | - Nancy M Heddle
- McMaster Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Jason P Acker
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
- Centre for Innovation, Canadian Blood Services, Edmonton, AB, Canada
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10
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Abstract
Autologous blood cell salvage reduces the need for postoperative allogeneic blood transfusion and alleviates immunologic reactions, so the technique is commonly used in cardiac surgery. The continuous autotransfusion system is a type of blood cell salvage device. Although the processing program of continuous autotransfusion system includes filtering of several materials from suctioned blood, such as clots, leukocytes, cytokines, and complement, we identified some unexpected blood clots in the reinfusion bag. Pathologic examination revealed that the clots were composed of fibrin, red blood cell aggregates, and histiocytes. We report two cases of these abnormal findings during the use of CATSmart in cardiac surgery.
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Affiliation(s)
- Jun Hyun Kim
- Anesthesiology and Pain Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Ja Young Bae
- Anesthesiology and Pain Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Sang Il Lee
- Anesthesiology and Pain Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Min Hee Heo
- Anesthesiology and Pain Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Kyung Tae Kim
- Anesthesiology and Pain Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Jang Su Park
- Anesthesiology and Pain Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Ji Yeon Kim
- Anesthesiology and Pain Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea
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11
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Raffo D, Perez Tito L, Pes ME, Fernandez Sasso D. Evaluation of DMSO dextrose as a suitable alternative for DMSO dextran in cord blood cryopreservation. Vox Sang 2019; 114:283-289. [PMID: 30734294 DOI: 10.1111/vox.12755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 11/21/2018] [Accepted: 01/07/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Umbilical cord blood is considered an alternative source of hematopoietic stem cells. Standard banking procedures use 50/55% DMSO in dextran 40 for cryopreservation and dextran-based solutions for thawing, however, due to the potential risk of crystallization of dextran, dextran 40 approved for clinical use has become limited or unavailable. This affects cryopreservation and thawing procedures. Carbohydrates, in particular sucrose, trehalose and glucose, have been shown to be effective in reducing cell damage during dehydration and have cryoprotective potential. We aim to study a 50/55% DMSO in 5% dextrose cryopreservation solution as an alternative to DMSO dextran. MATERIALS AND METHODS Eighteen samples were divided into two aliquots and cryopreserved, one using standard solution and the other with DMSO dextrose experimental solution. Both aliquots were thawed and diluted with PBS or saline. Total nucleated cells counts, 7-AAD viability of CD45+ cells and recovery of CD34+ viable cells were assessed on thawed samples and compared between pair of aliquots. RESULTS No differences were observed in the total nucleated cells recovery between cryopreservation solutions, however, higher viability and CD34+ viable cells recoveries were observed using the experimental solution. CONCLUSION Results showed that DMSO dextrose cryopreservation solution had better results than the standard solution when thawed in an isotonic solution. This indicates that DMSO dextrose is probably a better alternative for direct infusion or when dextran thawing solutions are unavailable. Viability of CD45+ cells and recovery of CD34+ viable cells have positive correlation with engraftment, highlighting the relevance of the optimization of the cryopreservation and thawing process.
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12
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Klinkenberg EF, Langi Sasongko PKB, de Kort WLAM, van Weert JCM, Fransen MP, Huis In 't Veld EMJ. The supply chain of migrant blood donors: an organisational interview study. Vox Sang 2019; 114:145-153. [PMID: 30623984 PMCID: PMC6850342 DOI: 10.1111/vox.12748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 11/21/2018] [Accepted: 12/14/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND OBJECTIVES Migrant blood donors are underrepresented worldwide resulting in shortages of compatible blood products. Prior studies focused on individual barriers and motivators of potential blood donors, but no studies addressed organisational factors of the blood supply chain. This study explored the perceptions and experiences in recruitment and retention of migrant - and potentially rare-blood donors among staff members within the blood supply chain and identified obstacles and solutions in this chain. MATERIALS AND METHODS The study was conducted at Sanquin, the national blood supply organisation of the Netherlands. Qualitative in-depth interviews were done among key staff members (N = 17). Expert validity was assessed in three feedback meetings. RESULTS Seven staff members believed there is a shortage of migrant blood donors, while five believed there is not. However, there was a consensus that it may become a problem in the future due to demographic changes. The perceived obstacles to recruit and retain migrant donors were difficulties in determining how many migrant donors are needed and recruiting them, excluding potentially rare donors prior to donation, limited use of extended phenotyping and high blood typing and frozen storage costs. The possible solutions to increase blood pool diversity lay in registering donor ethnicity, specialised information provision for donors, reconsidering eligibility criteria and optimising blood typing strategies. CONCLUSION Whilst recruitment of migrant blood donors is perceived by staff as difficult, various organisational policies and guidelines seem to hinder retention. Improvements in the blood supply chain may be achieved by addressing logistics, current procedures and registration of ethnicity.
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Affiliation(s)
- Elisabeth F Klinkenberg
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands.,Department of Public Health, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Wim L A M de Kort
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands.,Department of Public Health, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, the Netherlands
| | - Julia C M van Weert
- Amsterdam School of Communication Research/ASCoR, University of Amsterdam, Amsterdam, the Netherlands
| | - Mirjam P Fransen
- Department of Public Health, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, the Netherlands
| | - Elisabeth M J Huis In 't Veld
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands.,Department of Cognitive Science and Artificial Intelligence, Tilburg University, Tilburg, the Netherlands
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13
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Enten G, Dalvi P, Martini N, Kausch K, Gray A, Landrigan M, Mangar D, Camporesi E. Rapid bedside rejuvenation of red blood cell with an autologous cell salvage device. Vox Sang 2018; 113:562-568. [PMID: 29971786 DOI: 10.1111/vox.12671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 04/03/2018] [Accepted: 05/09/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND OBJECTIVES During storage, red blood cells (RBCs) undergo physicochemical changes which affect the quality, function, and in vivo survival of transfused packed RBCs (pRBC). Changes include decreased 2,3-diphosphoglycerate (2,3-DPG) levels, decreased ATP, changes in mechanical properties and oxidative injury. RBC rejuvenation is a method used to increase levels of 2,3-DPG and ATP in pRBCs. This process requires incubating the pRBCs with a rejuvenation solution and subsequent washing. Standard blood bank protocols using the COBE 2991 Cell Processor require several hours of preparation. The objective of this study was to verify if a bedside protocol for rejuvenating pRBC and washing with the Sorin Xtra autologous cell salvage system could be used. MATERIALS AND METHODS Outdated pRBC units were obtained and rejuvenated in a model operating suite using a dry air incubator for 1 h at 37°C. Six units of pRBCs were pre-diluted with saline (1000 ml) and six units were not pre-diluted with saline. All units were washed with normal saline (1000 ml) using an apheresis-design cell salvage device in manual mode and wash volume set to 3000 ml. Samples were collected and analyzed for standard RBC quality parameters at baseline and post-wash. RESULTS Total pRBC wash efficiency was 94% ± 12% at a final hematocrit of 67.7 ± 5.9% while maintaining post-wash hemolysis 0.24 ± 0.12 %. Pre-dilution prior to washing did not confer statistically significant differences in final RBC quality parameters with the notable exceptions of calculated hemolysis and supernatant potassium levels (P < 0.05). The washing process can be completed within 10 min. The post-wash RBC parameters are appropriate for immediate transfusion to patients.
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Affiliation(s)
- G Enten
- TeamHealth Anesthesia Research Institute, Tampa, FL, USA
| | - P Dalvi
- TeamHealth Anesthesia Research Institute, Tampa, FL, USA
| | - N Martini
- Tampa General Hospital, Tampa, FL, USA
| | | | - A Gray
- Citra Labs, LLC (a Zimmer Biomet company), Braintree, MA, USA
| | | | - D Mangar
- TeamHealth Anesthesia, Tampa, FL, USA
| | - E Camporesi
- TeamHealth Anesthesia Research Institute, Tampa, FL, USA
- TeamHealth Anesthesia, Tampa, FL, USA
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14
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Abstract
Blood transfusion is made possible because, in most countries and organizations, altruistic individuals voluntarily, anonymously, and generously donate (without compensation) either whole blood or separated components that are then processed and distributed by professionals, prior to being allocated to recipients in need. Being part of modern medicine, blood transfusion uses so-called standard blood components when relative to cellular fractions and fresh plasma. However, as will be discussed in this paper, strictly speaking, such so-called labile blood components are not completely standard. Furthermore, the prevalent system based on voluntary, non-remunerated blood donation is not yet universal and, despite claims by the World Health Organization that 100% of blood collection will be derived from altruistic donations by 2020 (postponed to 2025), many obstacles may hinder this ambition, especially when relative to the collection of the enormous amount of plasma destined for fractionation into plasma derivative or drugs. Finally, country organizations also vary due to the economy, sociology, politics, and epidemiology. This paper then, discusses the particulars (of which ethical considerations) of blood transfusion diversity and the consequences for donors, patients, and society.
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Affiliation(s)
- Olivier Garraud
- Faculty of Medicine, University of Lyon, Saint-Etienne, France
- Institut National de la Transfusion Sanguine, Paris, France
| | - Jean-Daniel Tissot
- Transfusion Interrégionale CRS, Epalinges, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
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15
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Bomberg H, Volk T, Biedler A, Schneider SO. Impact of intraoperative blood salvage on monocyte subsets alteration and intracellular tumor necrosis factor-α production. J Biomed Mater Res A 2017; 106:815-821. [PMID: 29094483 DOI: 10.1002/jbm.a.36281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 10/23/2017] [Accepted: 10/27/2017] [Indexed: 11/09/2022]
Abstract
Intraoperative salvaged blood is used to reduce allogeneic blood transfusion in orthopedic surgery patients. However, salvaged blood reinfusion may lead to immune reactions. Salvaged and venous blood from 20 patients undergoing hip arthroplasty was processed. The salvaged samples were mixed with patients' venous blood and incubated in absence or presence of lipopolysaccharide. SAMPLES Venous: venous patient blood (n = 20). Native: mixed salvaged native blood (n = 20). Filtered: mixed salvaged leukocyte filtered blood (n = 20). Irradiated: mixed salvaged irradiated blood (n = 20). The frequency of the surface receptors CD14, HLA-DR, and intracellular tumor necrosis factor (TNF)-α on peripheral blood mononuclear cells was analyzed by fluorescence-activated cell sorting analysis. The frequency of unstimulated CD14low and CD14high cells as well as unstimulated HLA-DR and TNF-α positive monocytes was comparable between venous and filtered salvaged blood. However, native and irradiated salvaged blood increased compared with venous (p < 0.05) and filtered salvaged blood (p < 0.05) for unstimulated CD14low cells, HLA-DR, and TNF-α positive monocytes. Stimulated intracellular TNF-α positive monocytes were decreased in native, filtered, and irradiated salvaged blood compared with venous blood (p < 0.05). Processing perioperative salvaged blood with leukofiltration minimizes the influence on monocytes activation compared with native and irradiated salvaged blood. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 815-821, 2018.
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Affiliation(s)
- Hagen Bomberg
- Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, Saarland University Medical Center, Homburg, Saar, Germany
| | - Thomas Volk
- Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, Saarland University Medical Center, Homburg, Saar, Germany
| | - Andreas Biedler
- Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, Saarland University Medical Center, Homburg, Saar, Germany
| | - Sven O Schneider
- Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, Saarland University Medical Center, Homburg, Saar, Germany
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16
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Khanal G, Huynh RA, Torabian K, Xia H, Vörös E, Shevkoplyas SS. Towards bedside washing of stored red blood cells: a prototype of a simple apparatus based on microscale sedimentation in normal gravity. Vox Sang 2017; 113:31-39. [PMID: 29067695 DOI: 10.1111/vox.12605] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 09/02/2017] [Accepted: 09/20/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Infusion of by-products of red blood cell (RBC) storage-induced degradation as well as of the residual plasma proteins and the anticoagulant-preservative solution contained in units of stored blood serve no therapeutic purpose and may be harmful to some patients. Here, we describe a prototype of a gravity-driven system for bedside washing of stored RBCs. MATERIALS AND METHODS Stored RBCs were diluted to 10% haematocrit (Hct) with normal saline, matching the conventional washing procedure. The dilute RBC suspensions were passed through a column of coiled tubing to allow RBC sedimentation in normal gravity, thus separating them from the washing solution. Washed RBCs were collected using bifurcations located along the tubing. Washing efficiency was quantified by measuring Hct, morphology, deformability, free haemoglobin and total-free protein. RESULTS The gravity-driven washing system operating at 0·5 ml/min produced washed RBCs with final Hct of 36·7 ± 3·4% (32·3-41·2%, n = 10) and waste Hct of 3·4 ± 0·7% (2·4-4·3%, n = 10), while removing 80% of free haemoglobin and 90% of total-free protein. Washing improved the ability of stored RBCs to perfuse an artificial microvascular network by 20%. The efficiency of washing performed using the gravity-driven system was not significantly different than that of conventional centrifugation. CONCLUSIONS This proof-of-concept study demonstrates the feasibility of washing stored RBCs using a simple, disposable system with efficiency comparable to that of conventional centrifugation, and thus represents a significant first step towards enabling low-cost washing of stored blood at bedside.
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Affiliation(s)
- G Khanal
- Department of Biomedical Engineering, University of Houston, Houston, TX, USA
| | - R A Huynh
- Department of Biomedical Engineering, University of Houston, Houston, TX, USA
| | - K Torabian
- Department of Biomedical Engineering, University of Houston, Houston, TX, USA
| | - H Xia
- Department of Biomedical Engineering, University of Houston, Houston, TX, USA
| | - E Vörös
- Department of Biomedical Engineering, University of Houston, Houston, TX, USA
| | - S S Shevkoplyas
- Department of Biomedical Engineering, University of Houston, Houston, TX, USA
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17
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Hackstein H, Möller A, Gerlach M, Sachs U, Bein G. Prospective quality control study of a novel gravity-driven whole blood separation system suitable for humanitarian crises. Vox Sang 2017; 112:806-809. [PMID: 28952151 DOI: 10.1111/vox.12595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 07/15/2017] [Accepted: 08/29/2017] [Indexed: 11/28/2022]
Abstract
Centrifugation-based whole blood (WB) separation represents the worldwide standard but it depends on electricity and infrastructure. We have prospectively evaluated a novel hollow-fibre WB separation system that does not require manual priming or blood flow regulation (n = 29). RBC units contained sufficient Hb (50·4 g ± 4·3), low leucocytes (90 000 ± 0·008), exhibited low haemolysis (0·57% ± 0·49) and robust ATP content (51·47% ± 8·2) after 43 days storage. Plasma units contained low leucocytes and mean coagulation factor activities for FV, FVIII and FXI were 47%, 90% and 68%, respectively. RBC met quality specifications but plasma units exhibited reduced FV and FXI activity.
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Affiliation(s)
- H Hackstein
- Institute for Clinical Immunology and Transfusion Medicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - A Möller
- Institute for Clinical Immunology and Transfusion Medicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - M Gerlach
- Institute for Clinical Immunology and Transfusion Medicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - U Sachs
- Institute for Clinical Immunology and Transfusion Medicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - G Bein
- Institute for Clinical Immunology and Transfusion Medicine, Justus-Liebig-University Giessen, Giessen, Germany
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18
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Marks DC, van der Meer PF. Serum eye drops: a survey of international production methods. Vox Sang 2017; 112:310-317. [PMID: 28332214 DOI: 10.1111/vox.12502] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 01/24/2017] [Accepted: 01/25/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Serum eye drops (SEDs) are used to treat dry eye syndrome and non-healing corneal lesions when other treatments fail. Despite many clinical studies demonstrating the efficacy of both autologous and allogeneic SEDs, there is no internationally harmonized method for producing SEDs. MATERIALS AND METHODS A 40-question survey requesting information regarding donor selection, blood collection and processing, infectious disease screening, shelf life and regulatory requirements for the production of autologous and allogeneic SEDs was developed by the Biomedical Excellence for Safer Transfusion Collaborative. Survey data were collected into a database via a secure web interface and then downloaded into Excel for further analysis. RESULTS A total of 55 responses were received, with 21 responses from centres indicating they produce SEDs. Based on the responses, collection and processing practices differ widely, according to the size of the centre making the SEDs, and their ability to collect, process and test the blood. CONCLUSION Despite divergences in the methods for producing SEDs, the end result is a small-volume aliquot of serum that can be administered by a patient at home. If more centres move from producing autologous to allogeneic SEDs, this may provide an opportunity for production methods to become more standardized internationally.
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Affiliation(s)
- D C Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - P F van der Meer
- Department of Product and Process Development, Sanquin Blood Supply, Amsterdam, The Netherlands
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19
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Chai-Adisaksopha C, Alexander PE, Guyatt G, Crowther MA, Heddle NM, Devereaux PJ, Ellis M, Roxby D, Sessler DI, Eikelboom JW. Mortality outcomes in patients transfused with fresher versus older red blood cells: a meta-analysis. Vox Sang 2017; 112:268-278. [PMID: 28220494 DOI: 10.1111/vox.12495] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 01/03/2017] [Accepted: 01/06/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND Among transfused patients, the effect of the duration of red blood cell storage on mortality remains unclear. This study aims to compare the mortality of patients who were transfused with fresher versus older red blood cells. METHODS We performed an updated systematic search in the CENTRAL, MEDLINE, EMBASE and CINAHL databases, from January 2015 to October 2016. RCTs of hospitalized patients of any age comparing transfusion of fresher versus older red blood cells were eligible. We used a random-effects model to calculate pooled risk ratios (RRs) with corresponding 95% confidence interval (CI). RESULTS We identified 14 randomized trials that enrolled 26 374 participants. All-cause mortality occurred in 1219 of 9531 (12·8%) patients who received a transfusion of fresher red blood cells and 1810 of 16 843 (10·7%) in those who received older red blood cells (RR: 1·04, 95% CI: 0·98-1·12, P = 0·90, I2 = 0%, high certainty for ruling out benefit of fresh blood, moderate certainty for ruling out harm of fresh blood). In six studies, in-hospital death occurred in 691 of 7479 (9·2%) patients receiving fresher red cells and 1291 of 14 757 (8·8%) receiving older red cells (RR: 1·06, 95% CI: 0·97-1·15, P = 0·81, I2 = 0%, high certainty for ruling out benefit of fresh blood, moderate certainty for ruling out harm of fresh blood). CONCLUSION Transfusion of fresher red blood cells does not reduce overall or in-hospital mortality when compared with older red blood cells. Our results support the practice of transfusing patients with the oldest red blood cells available in the blood bank.
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Affiliation(s)
- C Chai-Adisaksopha
- Department of Medicine, McMaster University, Hamilton, ON, Canada.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - P E Alexander
- Department of Medicine, McMaster University, Hamilton, ON, Canada.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - G Guyatt
- Department of Medicine, McMaster University, Hamilton, ON, Canada.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - M A Crowther
- Department of Medicine, McMaster University, Hamilton, ON, Canada.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.,Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - N M Heddle
- Department of Medicine, McMaster University, Hamilton, ON, Canada.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.,Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.,McMaster Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada.,Centre for Innovation Canadian Blood Services, Hamilton, ON, Canada
| | - P J Devereaux
- Department of Medicine, McMaster University, Hamilton, ON, Canada.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.,Population Health Research Institute, Hamilton, ON, Canada
| | - M Ellis
- Meir Medical Centre Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - D Roxby
- SA Pathology Transfusion Service, Flinders Medical Centre and Flinders University, Adelaide, SA, Australia
| | - D I Sessler
- Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA
| | - J W Eikelboom
- Department of Medicine, McMaster University, Hamilton, ON, Canada.,Population Health Research Institute, Hamilton, ON, Canada.,Thrombosis & Atherosclerosis Research Institute, Hamilton, ON, Canada
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20
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Lynch SA, Mullen AM, O'Neill EE, García CÁ. Harnessing the Potential of Blood Proteins as Functional Ingredients: A Review of the State of the Art in Blood Processing. Compr Rev Food Sci Food Saf 2017; 16:330-344. [PMID: 33371539 DOI: 10.1111/1541-4337.12254] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 12/28/2016] [Accepted: 01/03/2017] [Indexed: 01/17/2023]
Abstract
Blood is generated in very large volumes as a by-product in slaughterhouses all around the world. On the one hand, blood generation presents a serious environmental issue because of its high pollutant capacity; however, on the other hand, blood has the potential to be collected and processed to generate high-added-value food ingredients based on its exceptional nutritive value and its excellent functional properties. In this paper, we review the current state of the art for blood processing, from collection to final recovery of protein isolates, the functional properties of blood, impact of processing on functional properties, and potential applications as food ingredients. Furthermore, future challenges are outlined for this underutilized and abundant product from the meat industry.
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Affiliation(s)
- Sarah A Lynch
- Teagasc Food Research Centre, Food Quality and Sensory Science, Ashtown, Dublin, 15, Ireland
| | - Anne Maria Mullen
- Teagasc Food Research Centre, Food Quality and Sensory Science, Ashtown, Dublin, 15, Ireland
| | - Eileen E O'Neill
- Dept. of Food and Nutritional Sciences, Univ. College Cork, Cork, Ireland
| | - Carlos Álvarez García
- Teagasc Food Research Centre, Food Quality and Sensory Science, Ashtown, Dublin, 15, Ireland
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21
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Loh YS, Tan S, Kwok M, Stark MJ, Marks DC. Reduction of biological response modifiers in the supernatant of washed paediatric red blood cells. Vox Sang 2016; 111:365-373. [PMID: 27864978 DOI: 10.1111/vox.12442] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 06/01/2016] [Accepted: 07/07/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Washing of red blood cells (RBC) can reduce unwanted biological response modifiers (BRMs) that can mediate transfusion complications in infants. The aim of this study was to examine the in vitro quality and the changes in BRMs following washing in paediatric RBC units. MATERIALS AND METHODS A pool and split design was used to prepare RBC (either 1 or 4 days old; n = 26 pairs). One unit was washed with 0·9% saline by centrifugation and then resuspended in SAG-M, while the other remained unwashed. Each RBC unit was divided to produce four units of paediatric-sized components. Samples were taken after 3 h and subsequently on days 1, 2, 7 and 14 post-wash. RESULTS Washing of RBC resulted in some red cell loss, with a minor increase in haemolysis. Washing effectively reduced supernatant potassium and IgA, as well as cytokines and complement proteins. RBC microparticles were significantly reduced in RBC washed at 1, but not 4 days post-collection. Incubation with supernatant from unwashed but not washed RBC led to endothelial cell activation, with increased cell surface expression of CD62E (E-selectin) and CD106 (VCAM). CONCLUSION Although washing affected some aspects of the in vitro quality of RBC, it effectively reduced the concentration and activity of BRMs in the supernatant of RBC. Such a reduction may be clinically beneficial in selected patient groups.
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Affiliation(s)
- Y S Loh
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - S Tan
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - M Kwok
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - M J Stark
- School of Paediatrics and Reproductive Health, The Robinson Institute, University of Adelaide, Adelaide, NSW, Australia
| | - D C Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
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22
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Proffitt S, Thomas S, Swann I, Popovsky MA, Smith DJ, Roberts DJ, Cardigan R. Storage of washed or irradiated red cells in AS-7 improves their in vitro characteristics. Vox Sang 2015; 109:203-13. [PMID: 25900147 DOI: 10.1111/vox.12271] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 01/16/2015] [Accepted: 02/03/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND AS-7 is a new alkaline hypotonic red cell additive solution (AS) shown to improve red cell quality during storage compared with AS-1. We sought to compare red cells stored in AS-7 with those stored in SAGM using RCC that were either untreated, or washed or irradiated on day 14 of storage. STUDY DESIGN AND METHODS A pooled and split study design was used to produce seven identical RCC (four in SAGM and three in AS-7). At day 14 following donation, two RCC (one in SAGM and one in AS-7) were gamma irradiated and three RCC (two in SAGM and one in AS-7) were washed and resuspended in either SAGM or AS-7. RCC were sampled for analysis throughout storage and at end of shelf life: day 28 for washed or irradiated and day 35 for untreated RCC. RESULTS For untreated, washed or irradiated RCC, those stored in AS-7 had lower haemolysis, red cell microvesicles and supernatant potassium content than RCC in SAGM. In addition, ATP levels and pH were better maintained in AS-7 RCC than in SAGM RCC. CONCLUSION These data suggest that the quality of these components may be improved by storage in AS-7 compared with SAGM.
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Affiliation(s)
- S Proffitt
- Component Development Laboratory, NHS Blood and Transplant, Cambridge, UK
| | - S Thomas
- Component Development Laboratory, NHS Blood and Transplant, Cambridge, UK
| | - I Swann
- Haemonetics Corporation, Braintree, MA, USA
| | | | - D J Smith
- NHS Blood and Transplant, Oxford Centre, John Radcliffe Hospital, Oxford, UK
| | - D J Roberts
- NHS Blood and Transplant, Oxford Centre, John Radcliffe Hospital, Oxford, UK.,Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - R Cardigan
- Component Development Laboratory, NHS Blood and Transplant, Cambridge, UK
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23
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Eom JE, Kim DS, Lee MW, Yu DK, Jin KS, Shin S, Lee SH, Sung KW, Koo HH, Yoo KH. Quality of functional haematopoietic stem/progenitor cells from cryopreserved human umbilical cord blood. Vox Sang 2014; 107:181-7. [PMID: 24517183 DOI: 10.1111/vox.12132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 01/02/2014] [Accepted: 01/03/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Transplantation of cryopreserved umbilical cord blood (UCB) can be used to treat a multitude of haematologic and immunological diseases. In this study, we examined the quality of UCB cryopreserved for 2 (group I), 4 (group II) and 6 (group III) years. METHODS The following parameters and procedures were used to test individual units of cryopreserved UCB: the number of total nucleated cells (TNC), cell viability, CFU-GM assay, T-cell activation in vitro and haematopoietic stem cell engraftment in NOD/SCID mice in vivo. RESULTS The TNC recovery rates for groups I, II and III were 106·2 ± 6·17%, 96·69 ± 6·39% and 100·38 ± 5·27%, respectively, and the mean percentages of viable cells after thawing were 86·88%, 86·38% and 87·43%. When TNC were plated at 5 × 10(3), the number of CFU-GM was 13·6 (group I), 13·8 (group II), 14·2 (group III) and 14·7 (fresh UCB). We confirmed that the huCD4(+) and huCD8(+) T cells within cryopreserved UCB are functionally responsive by assessment of activated huCD25(+) cells. Moreover, the percentage of huCD45(+) cells in the bone marrow was 4·32 ± 1·29% (group I), 4·48 ± 1·11% (group II), 4·40% ± 1·12% (group III) and 4·50% ± 0·66% (fresh UCB), and that in the peripheral blood was 14·69 ± 3·08% (group I), 15·24 ± 4·05% (group II), 15·74 ± 3·43% (group III) and 17·48 ± 3·74% (fresh UCB) in NOD/SCID mice infused with isolated huCD34(+) cells. CONCLUSION These results indicated that cryopreserved UCB units efficiently retrieve in functionally competent form and are suitable for transplantation.
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Affiliation(s)
- J-E Eom
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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