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The red cell storage lesion(s): of dogs and men.

Abstract The advent of preservative solutions permitted refrigerated storage of red blood cells. However, the convenience of having red blood cell inventories was accompanied by a disadvantage. Red cells undergo numerous physical and metabolic changes during cold storage, the "storage lesion(s)". Whereas controlled clinical trials have not confirmed the clinical importance of such changes, ethical and operational issues have prevented careful study of the oldest stored red blood cells. Suggestions of toxicity from meta-analyses motivated us to develop pre-clinical canine models to compare the freshest vs the oldest red blood cells. Our model of canine pneumonia with red blood cell transfusion indicated that the oldest red blood cells increased mortality, that the severity of pneumonia is important, but that the dose of transfused red blood cells is not. Washing the oldest red blood cells reduces mortality by removing senescent cells and remnants, whereas washing fresher cells increases mortality by damaging the red blood cell membrane. An opposite effect was found in a model of haemorrhagic shock with reperfusion injury. Physiological studies indicate that release of iron from old cells is a primary mechanism of toxicity during infection, whereas scavenging of cell-free haemoglobin may be beneficial during reperfusion injury. Intravenous iron appears to have toxicity equivalent to old red blood cells in the pneumonia model, suggesting that intravenous iron and old red blood cells should be administered with caution to infected patients.
PMID
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Authors

Mayor MeshTerms

Erythrocytes

Keywords
Journal Title blood transfusion = trasfusione del sangue
Publication Year Start




PMID- 28263166
OWN - NLM
STAT- MEDLINE
DA  - 20170306
DCOM- 20170310
LR  - 20170315
IS  - 1723-2007 (Print)
IS  - 1723-2007 (Linking)
VI  - 15
IP  - 2
DP  - 2017 Mar
TI  - The red cell storage lesion(s): of dogs and men.
PG  - 107-111
LID - 10.2450/2017.0306-16 [doi]
AB  - The advent of preservative solutions permitted refrigerated storage of red blood 
      cells. However, the convenience of having red blood cell inventories was
      accompanied by a disadvantage. Red cells undergo numerous physical and metabolic 
      changes during cold storage, the "storage lesion(s)". Whereas controlled clinical
      trials have not confirmed the clinical importance of such changes, ethical and
      operational issues have prevented careful study of the oldest stored red blood
      cells. Suggestions of toxicity from meta-analyses motivated us to develop
      pre-clinical canine models to compare the freshest vs the oldest red blood cells.
      Our model of canine pneumonia with red blood cell transfusion indicated that the 
      oldest red blood cells increased mortality, that the severity of pneumonia is
      important, but that the dose of transfused red blood cells is not. Washing the
      oldest red blood cells reduces mortality by removing senescent cells and
      remnants, whereas washing fresher cells increases mortality by damaging the red
      blood cell membrane. An opposite effect was found in a model of haemorrhagic
      shock with reperfusion injury. Physiological studies indicate that release of
      iron from old cells is a primary mechanism of toxicity during infection, whereas 
      scavenging of cell-free haemoglobin may be beneficial during reperfusion injury. 
      Intravenous iron appears to have toxicity equivalent to old red blood cells in
      the pneumonia model, suggesting that intravenous iron and old red blood cells
      should be administered with caution to infected patients.
FAU - Klein, Harvey G
AU  - Klein HG
AD  - Department of Transfusion Medicine, Clinical Center, National Institutes of
      Health, Bethesda, MD, United States of America.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Italy
TA  - Blood Transfus
JT  - Blood transfusion = Trasfusione del sangue
JID - 101237479
SB  - IM
MH  - Animals
MH  - Blood Preservation/*adverse effects
MH  - Disease Models, Animal
MH  - Dogs
MH  - Erythrocyte Transfusion/*adverse effects
MH  - *Erythrocytes
MH  - Female
MH  - Humans
MH  - Male
MH  - Pneumonia/*etiology/*metabolism
PMC - PMC5336330
EDAT- 2017/03/07 06:00
MHDA- 2017/03/11 06:00
CRDT- 2017/03/07 06:00
PHST- 2015/11/07 [received]
PHST- 2015/11/15 [accepted]
AID - 2017.0306-16 [pii]
AID - 10.2450/2017.0306-16 [doi]
PST - ppublish
SO  - Blood Transfus. 2017 Mar;15(2):107-111. doi: 10.2450/2017.0306-16.

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