RES phagocytosis in children with homozygous β‐thalassemia in relation to blood transfusion

Dimitriou, P.; Giamouris, J.; Nicolaidou, Polyxeni; Antipas, S. E.; Fretzayas, Andrew; Messaropoulos, T.; Karpathios, T

doi:10.1111/j.1600-0609.1986.tb02630.x

Cited by 6 publications

(2 citation statements)

References 7 publications

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“…a. Blood transfusion did not significantly affect the parameters of both kinetics studied in embolized thalassemics, in contrast to what happens in nonsplenectomized patients (9,12,13).…”

Section: Discussionmentioning

confidence: 86%

“…Since it is established that the splenic function of nonsplenectomized thalassemics is ameliorated by blood transfusion (9), this finding signifies that the functional behavior of post-PSE splenic remnants has shifted towards the normal range. c. In embolized thalassemic patients, the slope of the curve representing the relationship between the dose of radiocolloid and the rate of its phagocytosis appeared not to be significantly different than that found in nonsplenectomized thalassemics after blood transfusion, when intrasplenic blood circulation is improved (12,13). This shows that, in embolized thalassemics, the permeability of the RES vascular bed is not affected by temporary changes in circulatory factors, such as those present in nonsplenectomized patients prior to blood transfusion, the ERBF being thus analogous to the amount of the remaining RES tissue alone.…”

Section: Discussionmentioning

confidence: 92%

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Assessment of splenic and RES function of patients with thalassemia major long after partial splenic embolization: In vivo clearance study

Germenis

Antipas

Dimitriou

et al. 1988

European J of Haematology

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The activity of the remaining reticuloendothelial system (RES) and the function of the splenic remnants was estimated in 5 thalassemic patients who had undergone successful partial splenic embolization (PSE) 6 yr previously. The kinetics of 125I‐heat‐denatured human albumin as well as that of 51Cr‐heat‐damaged homologous red blood cells were applied for this purpose and the parameters derived were compared to those of nonsplenectomized as well as splenectomized thalassemics with the following results: (a) The parameters of splenic function in embolized thalassemics were found to be within the limits observed in nonsplenectomized patients. (b) Their maximum phagocytic capacity was significantly lower, not only than that found in nonsplenectomized, but also than in thalassemic patients splenectomized at about the same time. It is concluded that, 6 yr after PSE has been performed, a reorientation of the altered circulatory dynamics has taken place in the splenic remnants allowing previously blockaded areas to gain normal function. It therefore seems that, despite the continuing hemolytic stimulus, RES hyperplasia is prevented, resulting in the stable, low‐level transfusion requirements that have been observed in embolized thalassemics.

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“…a. Blood transfusion did not significantly affect the parameters of both kinetics studied in embolized thalassemics, in contrast to what happens in nonsplenectomized patients (9,12,13).…”

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 92%

Assessment of splenic and RES function of patients with thalassemia major long after partial splenic embolization: In vivo clearance study

Germenis

Antipas

Dimitriou

et al. 1988

European J of Haematology

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Function of reticuloendothelial system in splenectomised thalassemics

Germenis

Dimitriou

Vrettou

et al. 1988

Blut

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The activity of reticuloendothelial system (RES) was estimated in 19 patients with beta-thalassemia major, 20 +/- 4 years old, who had undergone successful splenectomy 6 +/- 5 years previously. The kinetics of 125I denatured human serum albumin in low and large doses was applied for this purpose and the parameters derived (effective RES blood flow-ERBF- and maximum phagocytic capacity-PCmax) were compared to those of nonsplenectomized thalassemics, detected in previous works, as well as to those of 13 healthy controls. In splenectomised thalassemics both parameters of RES activity were found significantly lower than those of nonsplenectomized patients (p less than 0.001). Compared to those of healthy controls, PCmax of splenectomised thalassemics was found not to be significantly different, while ERBF was significantly lower (p less than 0.001). No correlation was noted between the above parameters of RES function and the age of the patients, the age at which splenectomy was performed, the time lapsed since the operation, the amount of blood transfused to the patients after splenectomy or their serum ferritin levels. A pilot study performed in 6 out of the 19 splenectomised patients did not reveal any effect of blood transfusion on RES function parameters, by contrast to observations in nonsplenectomized thalassemics. The results of this study suggest that in splenectomised thalassemics the remaining RES reacts to the continuing hemolytic stimulus in a manner different than that of splenic RES of nonsplenectomized patients and account for, at least in part, the predisposition of the former group to infections.

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Kinetics of heat-damaged homologous erythrocytes

et al. 1990

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A new theoretical five-compartmental model (5CM) was developed for analysis of the clearance of heat-damaged erythroctes (HDE) labelled with chromium 51. Besides the HDE-spleen interaction, this new model also takes into account the interaction between extrasplenic reticuloendothelial (RES) sites and HDE, i.e. the hepatic clearance of fragmented erythrocytes (FE). Accordingly, HDE clearance curves are analysed into three exponential components, the fastest of which describes the RES-FE interaction, whereas the others describe the splenic clearance of spherocytes. Therefore, an estimation of the effective liver blood flow for HDE (ELBF) was achieved, along with a series of parameters describing splenic function. The 5CM proved to be more efficient than a previously proposed three-compartmental model (3CM) in the mathematical description of HDE clearance. Comparison was made by applying both models to 37 experimental curves obtained from 20 patients with congenital hemolytic anemias. The values for the splenic function parameters calculated by 5CM analysis and the strong correlations observed among them offer evidence that this model provides an adequate approximation to the real conditions under which HDE clearance takes place. Furthermore, a detailed quantitative analysis of the pooling of spherocytes within the spleen was attempted in this work, and this phenomenon was found to compete with splenic irreversible spherocyte trapping. The ELBF proved to be closely correlated with the hemodynamic splenic parameters, following first-order kinetics, as do low-dose colloids.

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RES phagocytosis in children with homozygous β‐thalassemia in relation to blood transfusion

Cited by 6 publications

References 7 publications

Assessment of splenic and RES function of patients with thalassemia major long after partial splenic embolization: In vivo clearance study

Assessment of splenic and RES function of patients with thalassemia major long after partial splenic embolization: In vivo clearance study

Function of reticuloendothelial system in splenectomised thalassemics

Kinetics of heat-damaged homologous erythrocytes

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