Rejuvenation of allogenic red cells: benefits and risks
| Autor: | Gavin J. Murphy, Aujla H, Redjuvenate Trial Investigators, Tracy Kumar, Marcin J Woźniak |
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| Rok vydání: | 2017 |
| Předmět: |
Red Cell
business.industry Inflammation Hematology General Medicine 030204 cardiovascular system & hematology Pharmacology In vitro Lesion 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine chemistry In vivo medicine 030212 general & internal medicine medicine.symptom Inosine business Adverse effect Adenosine triphosphate medicine.drug |
| Zdroj: | Vox sanguinis. |
| ISSN: | 1423-0410 |
| Popis: | Background and objectives To review preclinical and clinical studies that have evaluated the effects of red cell rejuvenation in vivo and in vitro and to assess the potential risks and benefits from their clinical use. Materials and methods A systematic review and narrative synthesis of the intervention of red cell rejuvenation using a red cell processing solution containing inosine, pyruvate, phosphate and adenine. Outcomes of interest in vitro were changes in red cell characteristics including adenosine triphosphate (ATP), 2,3-diphosphoglycerate (2,3-DPG), deformability and the accumulation of oxidized lipids and other reactive species in the red cell supernatant. Outcomes in vivo were 24-h post-transfusion survival and the effects on oxygen delivery, organ function and inflammation in transfused recipients. Results The literature search identified 49 studies evaluating rejuvenated red cells. In vitro rejuvenation restored cellular properties including 2,3-DPG and ATP to levels similar to freshly donated red cells. In experimental models, in vivo transfusion of rejuvenated red cells improved oxygen delivery and myocardial, renal and pulmonary function when compared to stored red cells. In humans, in vivo 24-h survival of rejuvenated red cells exceeded 75%. In clinical studies, rejuvenated red cells were found to be safe, with no reported adverse effects. In one adult cardiac surgery trial, transfusion of rejuvenated red cells resulted in improved myocardial performance. Conclusion Transfusion of rejuvenated red cells reduces organ injury attributable to the red cell storage lesion without adverse effects in experimental studies in vivo. The clinical benefits of this intervention remain uncertain. |
| Databáze: | OpenAIRE |
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