Gregory Barshtein1, Axel R Pries2, Neta Goldschmidt3, Ayelet Zukerman1, Ariel Orbach1, Orly Zelig4, Dan Arbell5, Saul Yedgar6. 1. Department of Biochemistry, Hebrew University Faculty of Medicine, Jerusalem, Israel. 2. Charité-Universitätsmedizin Berlin, Berlin, Germany. 3. Department of Hematology, Hadassah University Hospital, Jerusalem, Israel. 4. Blood Bank, Hadassah-Hebrew University Hospital, Jerusalem, Israel. 5. Department of Pediatric Surgery, Hadassah- Hebrew University Hospital, Jerusalem, Israel. 6. Department of Biochemistry, Hebrew University Faculty of Medicine, Jerusalem, Israel. yedgar@md2.huji.ac.il.
Abstract
OBJECTIVE: There is a growing concern regarding the risks in the transfusion of PRBC, as numerous studies have reported negative transfusion outcomes, including reduced blood perfusion. In search of this phenomenon's mechanism, the effect of PRBC deformability, a major determinant of blood flow, on transfusion outcome was explored. METHODS: The effect of PRBC deformability was examined by the transfusion-induced change in recipients' ∆SBF, in β-TM patients, who are routinely treated with lifelong frequent transfusions. SBF was determined using a laser Doppler imager. RESULTS: ∆SBF was examined vs PRBC deformability, the transfusion-induced increase in ∆Hct and the recipients' SBF before transfusion (SBFB ). ∆SBF elevated with increasing PRBC deformability, with a highly significant dependence, while its elevation with ∆Hct was much less significant. ∆SBF was inversely proportional to the SBFB . CONCLUSIONS: This study provides, for the first time in humans, direct evidence that the deformability of transfused PRBC is a potent effector of transfusion outcome. Currently, PRBC are supplied primarily by the first-in-first-out criteria, while their functionality is ignored. The testing of PRBC hemodynamic quality would introduce a new paradigm into blood banking, which would contribute substantially to improving transfusion therapy.
OBJECTIVE: There is a growing concern regarding the risks in the transfusion of PRBC, as numerous studies have reported negative transfusion outcomes, including reduced blood perfusion. In search of this phenomenon's mechanism, the effect of PRBC deformability, a major determinant of blood flow, on transfusion outcome was explored. METHODS: The effect of PRBC deformability was examined by the transfusion-induced change in recipients' ∆SBF, in β-TM patients, who are routinely treated with lifelong frequent transfusions. SBF was determined using a laser Doppler imager. RESULTS: ∆SBF was examined vs PRBC deformability, the transfusion-induced increase in ∆Hct and the recipients' SBF before transfusion (SBFB ). ∆SBF elevated with increasing PRBC deformability, with a highly significant dependence, while its elevation with ∆Hct was much less significant. ∆SBF was inversely proportional to the SBFB . CONCLUSIONS: This study provides, for the first time in humans, direct evidence that the deformability of transfused PRBC is a potent effector of transfusion outcome. Currently, PRBC are supplied primarily by the first-in-first-out criteria, while their functionality is ignored. The testing of PRBC hemodynamic quality would introduce a new paradigm into blood banking, which would contribute substantially to improving transfusion therapy.
Authors: Puneeth Guruprasad; Robert G Mannino; Christina Caruso; Hanqing Zhang; Cassandra D Josephson; John D Roback; Wilbur A Lam Journal: Am J Hematol Date: 2018-11-28 Impact factor: 10.047
Authors: Julie A Reisz; Vassilis L Tzounakas; Travis Nemkov; Artemis I Voulgaridou; Issidora S Papassideri; Anastasios G Kriebardis; Angelo D'Alessandro; Marianna H Antonelou Journal: Front Med (Lausanne) Date: 2018-01-11
Authors: N A M Dekker; D Veerhoek; N J Koning; A L I van Leeuwen; P W G Elbers; C E van den Brom; A B A Vonk; C Boer Journal: Anaesthesia Date: 2019-01-27 Impact factor: 6.955