Segments from red blood cell units should not be used for quality testing

Kurach, Jayme D.R.; Hansen, Arild E.; Turner, Tracey R.; Jenkins, Craig; Acker, Jason P.

doi:10.1111/trf.12303

Cited by 17 publications

(24 citation statements)

References 12 publications

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“…We tested if bag versus segment differences exist in nitrite oxidation kinetics; however, no differences were observed with the exception of slightly slower rates in the lag phase in segments. Interestingly, segment‐bag differences in hemolysis were observed with a trend toward increased Hb in the segment, consistent with published reports . In contrast, free heme was higher in the bags compared to segments.…”

Section: Discussionsupporting

confidence: 90%

“…Figures 7D and 7E show that there was a modest increase in hemolysisderived Hb from Day 35 to Day 42 in segments, but no changes in free heme. Interestingly, while a trend toward increase Hb in the segments vs bags was observed, consistent with previous studies, 33 the opposite was observed for free heme (Fig. 7E).…”

Section: Bag Versus Segment Samplingsupporting

confidence: 92%

“…The data presented were collected using RBCs obtained from segments attached to RBC units. Recent studies have shown that segments can differ from the bag; for example, hemolysis may be higher, but complement levels lower in the segment compared to the paired bag . We therefore compared nitrite oxidation kinetics, Prx‐2 oxidation, and Hb and heme levels in samples collected from paired bag and segments stored for 35 and 42 days.…”

Section: Resultsmentioning

confidence: 99%

“…Recent studies have shown that segments can differ from the bag; for example, hemolysis may be higher, but complement levels lower in the segment compared to the paired bag. 32,33 We therefore compared nitrite oxidation kinetics, Prx-2 oxidation, and Hb and heme levels in samples collected from paired bag and segments stored for 35 and 42 days. Figures 7A through 7C show that nitrite oxidation kinetics were faster with Day 42 RBCs compared to Day 35 RBCs.…”

Section: Bag Versus Segment Samplingmentioning

confidence: 99%

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Predicting storage‐dependent damage to red blood cells using nitrite oxidation kinetics, peroxiredoxin‐2 oxidation, and hemoglobin and free heme measurements

Oh¹,

Stapley²,

Harper³

et al. 2015

Transfusion

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Background Storage-dependent damage to RBCs varies significantly. Identifying RBC units that will undergo higher levels of hemolysis during storage may allow for more efficient inventory management decision-making. Oxidative-stress mediates storage-dependent damage to RBCs and will depend on the oxidant : antioxidant balance. We reasoned that this balance or redox tone will serve as a determinant of how a given RBC unit stores and that its assessment in “young” RBC will predict storage-dependent hemolysis. Study Design and Methods RBCs were sampled from bags and segments stored for 7d – 42d. Redox tone was assessed by nitrite oxidation kinetics and peroxiredoxin-2 (Prx-2) oxidation. In parallel, hemolysis was assessed by measuring cell-free hemoglobin and free-heme (hemin). Correlation analyses were performed to determine if d7 measurements predicted either the level of hemolysis at d35 or the increase in hemolysis during storage. Results Higher d7 Prx-2 oxidation was associated with higher d35 Prx-2 oxidation suggesting that early assessment of this parameter may identify RBCs that will incur the most oxidative damage during storage. RBCs that oxidized nitrite faster at d7 were associated with greatest levels of storage-dependent hemolysis and increases in Prx-2 oxidation. An inverse relationship between storage-dependent changes in oxyhemoglobin and free heme was observed underscoring an unappreciated reciprocity between these molecular species. Moreover, free heme was higher in the bag compared to paired segments, with opposite trends observed for free hemoglobin. Conclusion Measurement of Prx-2 oxidation, nitrite oxidation kinetics early during RBC storage may predict storage-dependent damage to RBC including hemolysis-dependent formation of free hemoglobin and heme.

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Section: Discussionsupporting

confidence: 90%

Section: Bag Versus Segment Samplingsupporting

confidence: 92%

Section: Resultsmentioning

confidence: 99%

Section: Bag Versus Segment Samplingmentioning

confidence: 99%

See 2 more Smart Citations

Predicting storage‐dependent damage to red blood cells using nitrite oxidation kinetics, peroxiredoxin‐2 oxidation, and hemoglobin and free heme measurements

Oh¹,

Stapley²,

Harper³

et al. 2015

Transfusion

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show abstract

“…A limitation in our measurements is that for human RBCs, we quantitated storage-dependent free heme and Hb formation from segments that are attached to RBC bags. Recent studies have shown that segments have higher levels of hemolysis relative to the paired bag, and our data demonstrated differences in complement levels also, but with levels being higher in the bag relative to the segment [37, 38]. Further studies evaluating cell-free heme formation in bags vs. segments is required.…”

Section: Discussionmentioning

confidence: 58%

Red blood cell washing, nitrite therapy, and antiheme therapies prevent stored red blood cell toxicity after trauma–hemorrhage

Stapley

Rodriguez

et al. 2015

Free Radical Biology and Medicine

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Transfusion of stored red blood cells (RBCs) is associated with increased morbidity and mortality in trauma patients. Pro-oxidant, pro-inflammatory and nitric oxide (NO) scavenging properties of stored RBC are thought to underlie this association. In this study we determined the effects of RBC washing, nitrite and anti-heme therapy on stored RBC-dependent toxicity in the setting of trauma-induced hemorrhage. A murine (C57bl/6) model of trauma-hemorrhage and resuscitation with 1 or 3 units of RBC stored for 0–10d was used. Tested variables included whether washing RBC to remove lower MWt components that scavenge NO, NO-repletion therapy using nitrite or mitigation of free heme-toxicity by heme scavenging or preventing TLR4 activation. Stored RBC toxicity was determined by assessment of acute lung injury indices (airway edema and inflammation) and survival. Transfusion with 5d RBC increased acute lung injury indexed by BAL protein and neutrophil accumulation. Washing 5d RBC prior to transfusion did not decrease this injury, whereas nitrite therapy did. Transfusion with 10d RBC elicited a more severe injury resulting in ~90% lethality, compared to <15% with 5d RBC. Both washing and nitrite therapy significantly protected against 10d RBC-induced lethality, suggesting that washing may be protective when the injury stimulus is more severe. Finally, a spectral deconvolution assay was developed to simultaneously measure free heme and hemoglobin in stored RBC supernatants, which demonstrated significant increases of both in stored human and mouse RBC. Transfusion with free heme partially recapitulated the toxicity mediated by stored RBC. Furthermore, inhibition of TLR4 signaling, which is stimulated by heme, using TAK-242, or hemopexin-dependent sequestration of free heme significantly protected against both 5d and 10d mouse RBC-dependent toxicity. These data suggest that RBC washing, nitrite therapy and / or anti-heme and TLR4 strategies may prevent stored RBC toxicities.

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Red Blood Cell Aging During Storage, Studied Using Optical Tweezers Experiment

et al. 2015

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This paper presents experimental and numerical studies of erythrocyte stretching, with a focus on the aging of red blood cells in an in vitro environment during storage. The experimental studies were performed using optical tweezers. The laser beam was used to pull and stretch a cell sedimented on a flat surface. A force calibration was obtained via a comparison of the experimental data with results from finite element simulations of the cell stretching. The experiments were performed using blood samples from blood bank donations made by three donors. The experiments were performed over 21 days of storage, and the estimate erythrocyte membrane shear modulus during this period increased from 2.5 to 13 lN/m.

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Segments from red blood cell units should not be used for quality testing

Abstract: The quality of samples from tubing segments is not representative of the quality of the corresponding RBC unit. Segments are not suitable surrogates with which to assess RBC quality.

Cited by 17 publications

References 12 publications

Predicting storage‐dependent damage to red blood cells using nitrite oxidation kinetics, peroxiredoxin‐2 oxidation, and hemoglobin and free heme measurements

Predicting storage‐dependent damage to red blood cells using nitrite oxidation kinetics, peroxiredoxin‐2 oxidation, and hemoglobin and free heme measurements

Red blood cell washing, nitrite therapy, and antiheme therapies prevent stored red blood cell toxicity after trauma–hemorrhage

Red Blood Cell Aging During Storage, Studied Using Optical Tweezers Experiment

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