Impact of Alloantigens and Storage-associated Factors on Stimulated Cytokine Response in an In Vitro  Model of Blood Transfusion

Biedler, A.; Schneider, Sven; Seyfert, Ullrich; Rensing, Hauke; Grenner, Sasha; Girndt, Matthias; Bauer, Inge; Bauer, Michael

doi:10.1097/00000542-200211000-00011

Cited by 62 publications

(59 citation statements)

References 37 publications

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“…In addition, in vitro allogeneic PRBC transfusion appears to have the potential to promote polymorphonuclear cell-mediated cytotoxicity and to suppress neutrophil locomotion (16) and apoptosis (17). Our findings of significant increases in proinflammatory cytokines after transfusion are in keeping with both in vitro evidence for induction of pro-and anti-inflammatory cytokines following PRBC exposure (18,19) and adult in vivo data (20). Specifically, PRBC transfusion has been demonstrated to result in significant increases in TNF-α (19) and IL-8 (21).…”

Section: Discussionsupporting

confidence: 83%

Plasma cytokines and markers of endothelial activation increase after packed red blood cell transfusion in the preterm infant

et al. 2012

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Background: Transfusion of packed red blood cells (PRBcs) saves lives in the neonatal critical care setting and is one of the most common interventions in the preterm infant. The number and volume of PRBc transfusions are associated with several major neonatal morbidities, although a direct causal link between transfusion and major neonatal morbidity is still to be proven. Transfusion-related immunomodulation (TRIM) may underlie these adverse outcomes, yet it has received little attention in the high-risk preterm infant. Methods: One transfusion event was studied in infants ≤28 wk gestation between 2 and 6 wk postnatal age (n = 28). Plasma inflammatory cytokines and markers of endothelial activation were measured in the infants before and 2-4 h after transfusion, as well as in the donor pack. results: Median (range) age at transfusion was 18 (14-39) days with the pretransfusion hemoglobin level at 9.8 (7.4-10.2) g/dl. Interleukin (IL)-1β (P = 0.01), IL-8 (P = <0.001), tumor necrosis factor-α (P = 0.008), and monocyte chemoattractant protein (P = 0.01) were increased after transfusion. a similar elevation in markers of endothelial activation was seen after transfusion with increased plasma macrophage inhibitory factor (P = 0.005) and soluble intracellular adhesion molecule-1 (P = <0.001). conclusion: Production of inflammatory cytokines and immunoactivation of the endothelium observed after the transfusion of PRBcs in the preterm infant may be a manifestation of TRIM. The implications of this emerging phenomenon within the preterm neonatal population warrant further investigation. t ransfusion of blood products is not benign. In adults, transfusion is an independent predictor of death and is associated with an increased incidence of multiorgan system failure, length of hospital stay, infection risk, and modulation of the immune system (1,2). Although the mechanisms underlying these associations are yet to be comprehensively characterized, a two-hit model of posttransfusion injury has been proposed (3). In the clinical setting of an underlying inflammatory state priming the recipient's immune system, transfusion of packed red blood cells (PRBCs) may trigger immune cell activation and related immunomodulation, resulting in frank inflammation (4). This transfusion-related immunomodulation (TRIM), encompassing not only adverse proinflammatory and immunosuppressive responses but also the whole spectrum of posttransfusion effects on organs and tissues, has been proposed to underlie much of the increased transfusionassociated morbidity and mortality seen in adults (4).In the neonatal population, there is an increasing awareness of the excess morbidity and mortality associated with PRBC transfusions (5,6). PRBC transfusions have been implicated in the development of problems not encountered in the adult population, including chronic lung disease (7), retinopathy of prematurity (8), and necrotizing enterocolitis (9,10), with the incidence and severity of these conditions correlating with the number and volume of PRBC tran...

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Section: Discussionsupporting

confidence: 83%

Plasma cytokines and markers of endothelial activation increase after packed red blood cell transfusion in the preterm infant

et al. 2012

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“…Group H received allogeneic blood transfusion; Group A received autologous whole blood transfusion. plasma components (Claas et al, 2001;Biedler et al, 2002). Patients with documented recurrence and metastasis of cancer at the time of blood drawing had the lower T cell counts of many of those studied (Kuss et al, 2004).…”

Section: ) Cd3mentioning

confidence: 99%

Effect of perioperative autologous versus allogeneic blood transfusion on the immune system in gastric cancer patients

Chen

Zhang

Gong

et al. 2007

J. Zhejiang Univ. - Sci. B

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Abstract:Background: Allogeneic blood transfusion-induced immunomodulation (TRIM) and its adverse effect on the prognosis of patients treated surgically for cancer remain complex and controversial. However, the potential risk associated with allogeneic blood transfusion has heightened interest in the use of autologous blood transfusion. In the present study, the serum concentrations of neopterin, interferon-gamma (IFN-γ), T lymphocyte subsets (CD3 + ratio had significantly decreased after operation, but decreased more significantly in group H (receiving allogeneic blood transfusion) than those in group A (receiving autologous whole blood transfusion) (P<0.05). On the 5th postoperative day, serum neopterin, IFN-γ, CD3 + , CD4+ T-cells, and CD4 + /CD8 + ratio returned to the baseline values in group A. In contrast, the above remain decreasing in group H, where there were no significant relations between serum neopterin and IFN-γ. Conclusion: Perioperative surgical trauma and stress have an immunosuppressive impact on gastric cancer patients. Allogeneic blood transfusion exacerbates the impaired immune response. Autologous blood transfusion might be significantly beneficial for immune-compromised patients in the perioperative period, clearly showing its superiority over allogeneic blood transfusion.

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“…Consequently, postoperative blood transfusions are common [9]. However, because of the well-documented risks of ABTs, such as transfusion-associated infections or immunomodulatory effects [2], a reduction in the use of ABT would be a great improvement. Although some authors reported the use of autologous retransfusion systems as a good opportunity to reduce perioperative blood loss [5,26,34,36], there is no consensus regarding whether retransfusion systems also can reduce the use of postoperative ABTs.…”

Section: Discussionmentioning

confidence: 99%

“…This work was performed at Department of Orthopaedic Surgery, Academic Teaching Hospital, Medical University of Innsbruck, Feldkirch, Austria. approximately two units [9]. Because of the inherent risks [10,33] such as transfusion-associated infections and immunomodulation [2] and economic considerations, one common goal in orthopaedic surgery is to reduce the need for allogenic blood transfusions (ABTs) through perioperative blood management [28]. Some studies support measures for reducing blood loss, which include preoperative blood donation [41], correction of preoperative anemia [37], pharmacologic agents such as tranexamic acid injection [29], and autologous retransfusion systems [5,8,26,34,36,43].…”

Section: Introductionmentioning

confidence: 99%

Does Single Use of an Autologous Transfusion System in TKA Reduce the Need for Allogenic Blood?: A Prospective Randomized Trial

Cip

Widemschek

Benesch

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Mechanical autotransfusion systems for washed shed blood (WSB) were introduced to reduce the need for postoperative allogenic blood transfusions (ABTs). Although some authors have postulated decreased requirements for ABT by using autologous retransfusion devices, other trials, mostly evaluating retransfusion devices for unwashed shed blood (USB), verified a small or no benefit in reducing the need for postoperative ABT. Because of these contradictory findings it is still unclear whether autologous retransfusion systems for WSB can reduce transfusion requirements. Questions/purposes We therefore asked whether one such autologous transfusion system for WSB can reduce the requirements for postoperative ABT. Methods In a prospective, randomized, controlled study, we enrolled 151 patients undergoing TKA. In Group A (n = 76 patients), the autotransfusion system was used for a total of 6 hours (intraoperatively and postoperatively) and the WSB was retransfused after processing. In Control Group B (n = 75 patients), a regular drain without suction was used. We used signs of anemia and/or a hemoglobin value less than 8 g/dL as indications for transfusion. If necessary, we administered one or two units of allogenic blood. Results Twenty-three patients (33%) in Group A, who received an average of 283 mL (range, 160-406 mL) of salvaged blood, needed a mean of 2

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Impact of Alloantigens and Storage-associated Factors on Stimulated Cytokine Response in an In Vitro Model of Blood Transfusion

Cited by 62 publications

References 37 publications

Plasma cytokines and markers of endothelial activation increase after packed red blood cell transfusion in the preterm infant

Plasma cytokines and markers of endothelial activation increase after packed red blood cell transfusion in the preterm infant

Effect of perioperative autologous versus allogeneic blood transfusion on the immune system in gastric cancer patients

Does Single Use of an Autologous Transfusion System in TKA Reduce the Need for Allogenic Blood?: A Prospective Randomized Trial

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