A Comparison of Red Cell Rejuvenation versus Mechanical Washing for the Prevention of Transfusion-associated Organ Injury in Swine
| Autor: | Gavin J. Murphy, Tracy Kumar, Alison H. Goodall, Nikol Sullo, Mintu Nath, William Dott, Rebecca Cardigan, Michael Wiltshire, Saqib Qureshi, Marcin J Woźniak, Nishith N. Patel |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Pathology Erythrocytes Endothelium Swine 030204 cardiovascular system & hematology Lung injury Lesion 03 medical and health sciences 0302 clinical medicine Suidae medicine Animals Humans Rejuvenation Kidney Red Cell biology business.industry Crystalloid Solutions Lung Injury biology.organism_classification Red cell storage Surgery Disease Models Animal 030104 developmental biology Anesthesiology and Pain Medicine medicine.anatomical_structure Blood Preservation Female medicine.symptom Isotonic Solutions business Erythrocyte Transfusion |
| Zdroj: | Anesthesiology. 128(2) |
| ISSN: | 1528-1175 |
| Popis: | Background We evaluated the effects of two interventions that modify the red cell storage lesion on kidney and lung injury in experimental models of transfusion. Methods White–landrace pigs (n = 32) were allocated to receive sham transfusion (crystalloid), 14-day stored allogeneic red cells, 14-day red cells washed using the red cells washing/salvage system (CATS; Fresenius, Germany), or 14-day red cells rejuvenated using the inosine solution (Rejuvesol solution; Zimmer Biomet, USA) and washed using the CATS device. Functional, biochemical, and histologic markers of organ injury were assessed for up to 24 h posttransfusion. Results Transfusion of 14 day red cells resulted in lung injury (lung injury score vs. sham, mean difference −0.3 (95% CI, −0.6 to −0.1; P = 0.02), pulmonary endothelial dysfunction, and tissue leukocyte sequestration. Mechanical washing reduced red cell–derived microvesicles but increased cell-free hemoglobin in 14-day red cell units. Transfusion of washed red cells reduced leukocyte sequestration but did not reduce the lung injury score (mean difference −0.2; 95% CI, −0.5 to 0.1; P = 0.19) relative to 14-day cells. Transfusion of washed red cells also increased endothelial activation and kidney injury. Rejuvenation restored adenosine triphosphate to that of fresh red cells and reduced microvesicle concentrations without increasing cell-free hemoglobin release. Transfusion of rejuvenated red cells reduced plasma cell-free hemoglobin, leukocyte sequestration, and endothelial dysfunction in recipients and reduced lung and kidney injury relative to 14-day or washed 14-day cells. Conclusions Reversal of the red cell storage lesion by rejuvenation reduces transfusion-associated organ injury in swine. |
| Databáze: | OpenAIRE |
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