Red blood cell storage and alloimmunization: a fact or a myth?

Castilho, Lilian

doi:10.1016/j.bjhh.2015.08.002

Cited by 3 publications

(3 citation statements)

References 11 publications

(14 reference statements)

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“…Pretransfusion refrigerated storage, for example, changes RBC morphology, metabolism, and overall posttransfusion recovery ( 41 ). While conflicting data certainly exist ( 42 , 43 ), one study in particular suggested that storage may have a bimodal impact on RBC alloimmunization, with intermediate lengths of storage enhancing RBC alloimmunization and greater storage lengths reducing or enhancing alloimmunization ( 30 ). In contrast, RBC irradiation, despite possible generation of damage-associated molecular patterns (DAMPs), does not appear to alter alloimmunization rates ( 44 ).…”

Section: The Epidemiology Of Rbc Alloimmunizationmentioning

confidence: 99%

The Development and Consequences of Red Blood Cell Alloimmunization

Arthur

Stowell

2023

Annu. Rev. Pathol. Mech. Dis.

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While red blood cell (RBC) transfusion is the most common medical intervention in hospitalized patients, as with any therapeutic, it is not without risk. Allogeneic RBC exposure can result in recipient alloimmunization, which can limit the availability of compatible RBCs for future transfusions and increase the risk of transfusion complications. Despite these challenges and the discovery of RBC alloantigens more than a century ago, relatively little has historically been known regarding the immune factors that regulate RBC alloantibody formation. Through recent epidemiological approaches, in vitro–based translational studies, and newly developed preclinical models, the processes that govern RBC alloimmunization have emerged as more complex and intriguing than previously appreciated. Although common alloimmunization mechanisms exist, distinct immune pathways can be engaged, depending on the target alloantigen involved. Despite this complexity, key themes are beginning to emerge that may provide promising approaches to not only actively prevent but also possibly alleviate the most severe complications of RBC alloimmunization. Expected final online publication date for the Annual Review of Pathology: Mechanisms of Disease, Volume 18 is January 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

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Section: The Epidemiology Of Rbc Alloimmunizationmentioning

confidence: 99%

The Development and Consequences of Red Blood Cell Alloimmunization

Arthur

Stowell

2023

Annu. Rev. Pathol. Mech. Dis.

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“…[9][10][11] Nevertheless, other clinical studies have not demonstrated such an association, [12][13][14] leading to uncertainty about the role or need for modification in current storage protocols and clinical practice to prevent or reduce RBC alloimmunization. 15 As clinical studies have examined collective alloimmunization rates toward a variety of distinct alloantigens, [9][10][11][12][13][14] apparent discrepancies regarding the impact of storage on RBC alloimmunization may reflect the distinct consequences of storage on alloimmunization against unique alloantigens. Here we present data testing this hypothesis using a murine model of RBC transfusion.…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, some clinical reports demonstrate increased alloimmunization associated with transfusion of RBC units stored for longer periods of time, 8 which have been supported by experimental murine studies demonstrating increased alloimmunization associated with RBC storage 9–11 . Nevertheless, other clinical studies have not demonstrated such an association, 12–14 leading to uncertainty about the role or need for modification in current storage protocols and clinical practice to prevent or reduce RBC alloimmunization 15 . As clinical studies have examined collective alloimmunization rates toward a variety of distinct alloantigens, 9–14 apparent discrepancies regarding the impact of storage on RBC alloimmunization may reflect the distinct consequences of storage on alloimmunization against unique alloantigens.…”

Section: Introductionmentioning

confidence: 99%

Storage differentially impacts alloimmunization to distinct red cell antigens following transfusion in mice

et al. 2023

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Introduction The impact of blood storage on red blood cell (RBC) alloimmunization remains controversial, with some studies suggesting enhancement of RBC‐induced alloantibody production and others failing to observe any impact of storage on alloantibody formation. Since evaluation of storage on RBC alloimmunization in patients has examined antibody formation against a broad range of alloantigens, it remains possible that different clinical outcomes reflect a variable impact of storage on alloimmunization to specific antigens. Methods RBCs expressing two distinct model antigens, HEL‐OVA‐Duffy (HOD) and KEL, separately or together (HOD × KEL), were stored for 0, 8, or 14 days, followed by detection of antigen levels prior to transfusion. Transfused donor RBC survival was assessed within 24 h of transfusion, while IgM and IgG antibody production were assessed 5 and 14 days after transfusion. Results Stored HOD or KEL RBCs retained similar HEL or KEL antigen levels, respectively, as fresh RBCs, but did exhibit enhanced RBC clearance with increased storage age. Storage enhanced IgG antibody formation against HOD, while the oppositive outcome occurred following transfusion of stored KEL RBCs. The distinct impact of storage on HOD or KEL alloimmunization did not appear to reflect intrinsic differences between HOD or KEL RBCs, as transfusion of stored HOD × KEL RBCs resulted in increased IgG anti‐HOD antibody development and reduced IgG anti‐KEL antibody formation. Conclusions These data demonstrate a dichotomous impact of storage on immunization to distinct RBC antigens, offering a possible explanation for inconsistent clinical experience and the need for additional studies on the relationship between RBC storage and alloimmunization.

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An overview of red blood cell and platelet alloimmunisation in transfusion

Garraud

Chiaroni

2022

Transfusion Clinique et Biologique

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Red blood cell storage and alloimmunization: a fact or a myth?

Cited by 3 publications

References 11 publications

The Development and Consequences of Red Blood Cell Alloimmunization

The Development and Consequences of Red Blood Cell Alloimmunization

Storage differentially impacts alloimmunization to distinct red cell antigens following transfusion in mice

An overview of red blood cell and platelet alloimmunisation in transfusion

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