Age of Transfused Blood: An Independent Predictor of Mortality Despite Universal Leukoreduction

Weinberg, Jordan A.; McGwin, Gerald; Griffin, Russell; Huynh, Vu; Cherry, Samuel A.; Marques, Marisa B.; Reiff, Donald A.; Kerby, Jeffrey D.; Rue, Loring W.

doi:10.1097/ta.0b013e31817c9687

Cited by 174 publications

(244 citation statements)

References 11 publications

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“…L2880, Sigma, Buchs, Switzerland) followed two hours later by intravenous (i.v.) injection of 5x10 8 or 1x10 9 RBC-MV in a total volume of 200µl PBS via the tail vain. At the indicated times, mice were sacrificed with thiopental and organs were harvested.…”

Section: Methodsmentioning

confidence: 99%

Erythrocyte-Derived Microvesicles Amplify Systemic Inflammation by Thrombin-Dependent Activation of Complement

Zecher

Čumpelik

Schifferli

2014

ATVB

111

100

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Objective-Transfusion of aged blood has been associated with increased morbidity and mortality in critically ill patients.During storage, erythrocytes release increasing numbers of microvesicles (red blood cell-derived microvesicles [RBC-MV]). We hypothesized that RBC-MV mediate some of the deleterious effects of aged blood transfusions. Approach and Results-We established a murine transfusion model using RBC-MV purified from aged mouse erythrocytes. Injection of RBC-MV into healthy mice had no effect. However, they aggravated pulmonary leukocyte sequestration and peripheral blood leukopenia induced by lipopolysaccharides. Lipopolysaccharide-induced proinflammatory cytokines were significantly increased in plasma after RBC-MV injection. These effects were not seen in C5aR-deficient mice. In vitro, RBC-MV bound C3 fragments after incubation with plasma but failed to bind immunoglobulins, C1q, or mannose-binding lectin. Preventing thrombin generation inhibited complement activation in vitro and in vivo and reversed the proinflammatory effects of RBC-MV in lipopolysaccharide-primed mice. Finally, the RBC-MV-induced phenotype was recapitulated using phosphatidylserineexpressing liposomes, suggesting that surface expression of phosphatidylserine by RBC-MV was mechanistically involved. Conclusions-These

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Section: Methodsmentioning

confidence: 99%

Erythrocyte-Derived Microvesicles Amplify Systemic Inflammation by Thrombin-Dependent Activation of Complement

Zecher

Čumpelik

Schifferli

2014

ATVB

111

100

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“…In September 2008, Weinberg and his colleagues reported on a review of 1813 trauma patients transfused at least 1 unit of red blood cells over a 7·5-year period [57]. The group performed by both contingency table and regression analysis of the relationship of numbers of units of long-stored red blood cells and mortality and found an association by regression but not in the contingency table analysis.…”

Section: Data From Clinical Studiesmentioning

confidence: 99%

Current issues relating to the transfusion of stored red blood cells

Zimrin¹,

2009

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The development of blood storage systems allowed donation and transfusion to be separated in time and space. This separation has permitted the regionalization of donor services with subsequent economies of scale and improvements in the quality and availability of blood products. However, the availability of storage raises the question of how long blood products can and should be stored and how long they are safe and effective. The efficacy of red blood cells was originally measured as the increment in haematocrit and safety began with typing and the effort to reduce the risk of bacterial contamination. Appreciation of a growing list of storage lesions of red blood cells has developed with our increasing understanding of red blood cell physiology and our experience with red blood cell transfusion. However, other than frank haemolysis, rare episodes of bacterial contamination and overgrowth, the reduction of oxygen-carrying capacity associated with the failure of some transfused cells to circulate, and the toxicity of lysophospholipids released from membrane breakdown, storage-induced lesions have not had obvious correlations with safety or efficacy. The safety of red blood cell storage has also been approached in retrospective epidemiologic studies of transfused patients, but the results are frequently biased by the fact that sicker patients are transfused more often and blood banks do not issue blood products in a random order. Several large prospective studies of the safety of stored red blood cells are planned.

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“…Regulations in many countries specify 42 days (6 weeks) as the shelf life for stored red blood cells (RBCs), and a first-in-first-out inventory management approach is standard. Large-scale clinical studies involving 200-1800 patients indicated that patients transfused with older RBCs tend to have a higher risk of mortality than those receiving fresher RBCs [1][2][3][4] .…”

Section: Introductionmentioning

confidence: 99%

Stiffness increase of red blood cells during storage

Zheng

Wang

et al. 2018

Microsyst Nanoeng

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In transfusion medicine, the deformability of stored red blood cells (RBCs) changes during storage in blood banks. Compromised RBC deformability can reduce the transfusion efficiency or intensify transfusion complications, such as sepsis. This paper reports the microfluidic mechanical measurement of stored RBCs under the physiological deformation mode (that is, folding). Instead of using phenomenological metrics of deformation or elongation indices (DI or EI), the effective stiffness of RBCs, a flow velocityindependent parameter, is defined and used for the first time to evaluate the mechanical degradation of RBCs during storage. Fresh RBCs and RBCs stored up to 6 weeks (42 days) in the blood bank were measured, revealing that the effective stiffness of RBCs increases over the storage process. RBCs stored for 1 week started to show significantly higher stiffness than fresh RBCs, and stored RBC stiffness degraded faster during the last 3 weeks than during the first 3 weeks. Furthermore, the results indicate that the time points of the effective stiffness increase coincide well with the degradation patterns of S-nitrosothiols (SNO) and adenosine triphosphate (ATP) in RBC storage lesions.

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Age of Transfused Blood: An Independent Predictor of Mortality Despite Universal Leukoreduction

Cited by 174 publications

References 11 publications

Erythrocyte-Derived Microvesicles Amplify Systemic Inflammation by Thrombin-Dependent Activation of Complement

Erythrocyte-Derived Microvesicles Amplify Systemic Inflammation by Thrombin-Dependent Activation of Complement

Current issues relating to the transfusion of stored red blood cells

Stiffness increase of red blood cells during storage

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