scholarly journals Oxygen in Red Blood Cell Concentrates: Influence of Donors’ Characteristics and Blood Processing

2020 ◽  
Vol 11 ◽  
Author(s):  
Manon Bardyn ◽  
Agathe Martin ◽  
Nora Dögnitz ◽  
Mélanie Abonnenc ◽  
Andrew Dunham ◽  
...  

Objective: Unexpectedly wide distribution (<10 to >90%) of hemoglobin oxygen saturation (sO2) within red cell concentrates (RCCs) has recently been observed. Causes of such variability are not yet completely explained whereas the roles of oxygen and oxidative lesions during the storage of RCCs are known. The objectives of the present study are to characterize sO2 distribution in RCCs produced in a Swiss blood center and to investigate the influence of processing and donors’ characteristics.Methods: The level of sO2 was measured in 1701 leukocyte-depleted RCCs derived from whole blood donations in both top–bottom (TB; component filtered, SAGM) and top–top (TT; whole blood filtration, PAGGSM) RCCs. The sO2 value was measured non-invasively through the PVC bag prior to storage by resonance Raman spectroscopy. Gender, age, blood type, hemoglobin level, and living altitude of donors, as well as process method and time-to-process were recorded.Results: Overall, the sO2 exhibited a wide non-Gaussian distribution with a mean of 51.2 ± 18.5%. Use of top-top kits resulted in a 16% higher sO2 (P < 0.0001) than with top-bottom ones. Waiting time before processing only had a modest impact, but the blood processing itself reduced the sO2 by almost 12% (P < 0.0001). sO2 was also significantly affected by some donors’ characteristics. RCCs from men exhibited 25% higher sO2 (P < 0.0001) than those donated by women. Multivariate analysis revealed that the apparent correlation observed with hemoglobin level and age was actually due to multicollinearity with the sex variable. Finally, we noticed no significant differences across blood type but found that altitude of residence was associated with the sO2 (i.e., higher in higher living place).Conclusion: These data confirm wide sO2 distribution in RCCs reported recently. The sO2 was impacted by the processing and also by donors’ characteristics such as the gender and the living altitude, but not by the hemoglobin level, blood group and donor age. This study provides new hints on the factors influencing red blood cells storage lesions, since they are known to be related to O2 content within the bags, giving clues to better process and to better store RCCs and therefore potentially improve the efficacy of transfusion.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Min Suk Chae ◽  
Mihyun Lee ◽  
Min Ho Choi ◽  
Je Uk Park ◽  
Misun Park ◽  
...  

Abstract Background Previous studies have reported the efficacy and safety of intravenous (IV) iron therapy during the perioperative period as an alternative and adjunct to allogeneic blood transfusion. Preemptive IV iron therapy provides noninferior hemoglobin levels on postoperative day (POD) 1 compared to autologous whole blood therapy (AWBT) in healthy patients who had undergone bimaxillary orthognathic surgery. Methods This was a prospective, patient-randomized, noninferiority trial. After excluding 2 patients, 64 patients were divided into two groups: the IV iron therapy group (patients received IV iron infusion 4 weeks before surgery; n = 32) and the AWBT group (2 units of autologous whole blood were collected 4 and 2 weeks before surgery; n = 32). The primary outcome was hemoglobin level on POD 1 and the prespecified noninferiority limit was − 1 g/dL. Results Baseline data were comparable, including hemoglobin and iron levels, between the two groups. Immediately before surgery, the levels of hemoglobin, iron, and ferritin were higher in the IV iron group than in the AWBT group. The mean treatment difference (iron group—whole blood group) in hemoglobin level on POD 1 between the two groups was 0.09 (95% CI = − 0.83 to 1.0). As the lower limit of the 95% CI (− 0.83) was higher than the prespecified noninferiority margin (δ = − 1), noninferiority was established. On POD 2, the hemoglobin level became lower in the iron group, which eventually led to greater requirement of allogeneic blood transfusion compared to the whole blood group. However, the iron group did not require allogeneic blood transfusion during or early after surgery, and the whole blood group showed continuously higher incidence of overt iron deficiency compared to the iron group. Conclusion As collection of autologous whole blood caused overt iron loss and anemia before surgery and intraoperative transfusion of whole blood was not able to prevent the occurrence of persistent iron deficiency after surgery, IV iron therapy was found to have potential benefits for iron homeostasis and subsequent erythropoiesis in healthy patients early after bimaxillary orthognathic surgery. Trial registration: Clinical Research Information Service, Republic of Korea, approval number: KCT0003680 on March 27, 2019. https://cris.nih.go.kr/cris/search/search_result_st01_kren.jsp?seq=15769&sLeft=2&ltype=my&rtype=my.


Author(s):  
Nicolas Malvaux ◽  
Anne Schuhmacher ◽  
Fanette Defraigne ◽  
Remy Jacob ◽  
Aicha Bah ◽  
...  

2020 ◽  
Author(s):  
Min Suk Chae ◽  
Mihyun Lee ◽  
Min Ho Choi ◽  
Je Uk Park ◽  
Misun Park ◽  
...  

Abstract Background: Previous studies have reported the efficacy and safety of intravenous (IV) iron therapy during the perioperative period as an alternative and adjunct to allogeneic blood transfusion. Preemptive IV iron therapy provides noninferior hemoglobin levels on postoperative day (POD) 1 compared to autologous whole blood therapy (AWBT) in healthy patients who had undergone bimaxillary orthognathic surgery.Methods: This was a prospective, patient-randomized, noninferiority trial. After excluding 2 patients, 64 patients were divided into two groups: the IV iron therapy group (patients received IV iron infusion 4 weeks before surgery; n = 32) and the AWBT group (2 units of autologous whole blood were collected 4 and 2 weeks before surgery; n = 32). The primary outcome was hemoglobin level on POD 1 and the prespecified noninferiority limit was –1 g/dL. Results: Baseline data were comparable, including hemoglobin and iron levels, between the two groups. Immediately before surgery, the levels of hemoglobin, iron, and ferritin were higher in the IV iron group than in the AWBT group. The mean treatment difference (iron group – whole blood group) in hemoglobin level on POD 1 between the two groups was 0.09 (95% CI = –0.83 to 1.0). As the lower limit of the 95% CI (–0.83) was higher than the prespecified noninferiority margin (δ = –1), noninferiority was established. On POD 2, the hemoglobin level became lower in the iron group, which eventually led to greater requirement of allogeneic blood transfusion compared to the whole blood group. However, the iron group did not require allogeneic blood transfusion during or early after surgery, and the whole blood group showed continuously higher incidence of overt iron deficiency compared to the iron group. Conclusion: As collection of autologous whole blood caused overt iron loss and anemia before surgery and intraoperative transfusion of whole blood was not able to prevent the occurrence of persistent iron deficiency after surgery, IV iron therapy was found to have potential benefits for iron homeostasis and subsequent erythropoiesis in healthy patients early after bimaxillary orthognathic surgery.Trial registration: Clinical Research Information Service, Republic of Korea, approval number: KCT0003680 on March 27, 2019https://cris.nih.go.kr/cris/search/search_result_st01_kren.jsp?seq=15769&sLeft=2&ltype=my&rtype=my


2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S358-S358
Author(s):  
Eunkyung Song ◽  
Huanyu Wang ◽  
Amy Leber ◽  
Preeti Jaggi

Abstract Background The interpretation of HAdV PCR from upper respiratory tract (RT) specimens can be challenging due to prolonged low grade viral shedding. We hypothesized that HAdV detection in the blood (viremia) is more common in acute HAdV infection with high respiratory viral burden (VB) compared with those with low VB in the RT. We sought to determine the frequency of HAdV viremia in immunocompetent children who have detectable HAdV in the RT. Methods We prospectively identified + HAdV in RT specimens from emergency department or inpatients using semi-quantitative real-time PCR (Ct <40) or multiplex respiratory viral PCR (FILMARRAY RESPIRATORY PANEL v1.7) and prospectively collected available whole blood from 8/2013 to 2/2015. Blood was considered positive for HAdV if Ct was <40 in whole blood. We compared virologic, including HAdV type from the RT and blood, and clinical characteristics between viremic and non-viremic groups using Mann–Whitney or chi-square as appropriate. Results There were 196 unique patients with + HAdV in RT specimens as well as available blood for PCR (median age=1.3 years old). Blood and RT samples were obtained on the same calendar day in 78% of patients. Among these 196 patients, 163 (83%) were hospitalized and 58 (36%) were admitted to PICU. HAdV was detected in the blood in 33% of patients. Upper respiratory tract infections were more common (P = 0.026) and the duration of fever at the time of enrollment was longer in the viremia group (3 vs. 2 days, P = 0.043). There was no difference in ICU admission between two groups. Coinfections with bacterial pathogens from sterile sites were only found in the non-viremic group (4%); these included S. aureus or pneumococcal bacteremia, E. coli urinary tract infections, or pneumococcal pneumonia. HAdV VB in RT were significantly higher in the viremia group (Ct median 25.01 vs.. 36.38, P < 0.0001). Species C was more predominant in the viremia group compared with non C (A, B/E, D, F) (P = 0.018). RT type was 100% concordant with blood type. Conclusion HAdV viremia is relatively common in immunocompetent children with HAdV infection in the RT. Subjects with viremia had significantly higher VB in the RT, but this didn’t seem to be correlated with disease severity. HAdV viremia may be useful tool to add further evidence of acute HAdV infection. Disclosures A. Leber, BioFIre Diagnostics: Research Contractor and Scientific Advisor, Research support, Speaker honorarium and Travel expenses


1991 ◽  
Vol 39 (12) ◽  
pp. 1603-1610 ◽  
Author(s):  
C L Finstad ◽  
B W Yin ◽  
C M Gordon ◽  
M G Federici ◽  
S Welt ◽  
...  

Monoclonal antibodies (MAb) C219 and JSB-1 have been used extensively in the analysis of P-glycoprotein expression in normal and malignant tissues. This study demonstrates that some commercial lots of these MAb, even those supplied as purified immunoglobulins, contain contaminating anti-A blood group antibodies. In both sources of reagent, the antibody was specific for a particular A structure, known as repetitive or Type 3 A. These observations may account for earlier studies showing polymorphic variation in P-glycoprotein expression in epithelial tissues and an apparent correlation with the A blood type of the donor. Such reactivity can be eliminated by absorption of anti-P-glycoprotein reagents with A erythrocytes. These data re-emphasize the importance of evaluating MAb samples for unsuspected contaminating antibodies.


Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 853-853 ◽  
Author(s):  
Boris Shenkman ◽  
Ulrich Budde ◽  
Dorothea Angerhaus ◽  
Reinhard Schneppenheim ◽  
Aharon Lubetsky ◽  
...  

Abstract Measurement of von Willebrand factor-cleaving protease (VWF-CP) activity is useful for diagnosis of thrombotic thrombocytopenic purpura (TTP), but the current methods are cumbersome. We recently introduced a simple method of TTP detection using the Cone and Plate(let) Analyzer (CPA), that was based on the observation that mixing of acute TTP plasma (50 μL) with normal whole blood (150 μL) induces a significant increase in platelet deposition (surface coverage, %SC) on polystyrene surface under flow condition (1800 s−1) (Brit J Haematol, 120: 597, 2003). The test was specific for TTP, since plasma from patients with HUS, APLS, ITP or HIT did not affect normal platelet deposition. In this study, we further explored the potential use of the CPA method in differential diagnosis of inherited and acquired TTP by increasing the shear rate and by inducing the VWF-CP activity with BaCl2. TTP or normal plasma was mixed with normal blood (type O+) and the surface covered by platelets was tested under shear rates ranging between 1800 s−1 to 2500 s−1. Maximal difference in SC between TTP and normal plasma was observed at a shear rate of 2050 s−1. Under these conditions, plasmas of 5 patients with inherited TTP (ITTP), and 11 patients with acquired TTP (ATTP) yielded comparable increase in SC of normal platelets in whole blood, i.e. 77±19% and 78±17%, respectively. However, experiments in which BaCl2 was added to allow activation of VWF-CP resulted in a substantial distinction between inherited and acquired TTP plasma. While addition of BaCl2 to normal or inherited TTP plasma, both mixed with normal blood, yielded similar reductions of SC by 41±12% and 51±19%, only 11±4% reduction of SC was observed when acquired TTP plasma was used. These results suggest that when normal or inherited TTP plasma is mixed with normal blood, activation of VWF-CP cleaves large VWF multimers giving rise to substantial reduction in SC, whereas in the case of acquired TTP plasma the inhibitor of VWF-CP abolishes BaCl2-induced activation of VWF-CP and the ensuing reduction in SC. We conclude that introduction of BaCl2 in the CPA at high shear conditions may be useful for differentiation between inherited and acquired TTP.


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