Activation of the contact system by filtration of platelet concentrates with a negatively charged white cell‐removal filter and measurement of venous blood bradykinin level in patients who received filtered platelets

Shiba, Masayuki; Tadokoro, Kenji; Sawanobori, Masakazu; Nakajima, Kazunori; Suzuki, Kazuyuki; Juji, Takeo

doi:10.1046/j.1537-2995.1997.37597293873.x

Cited by 92 publications

(59 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The report did confirm the previously observed association of transfusion–induced hypotension associated with the use of bedside filters [11]. Transfusion–related infections deserve a mention.…”

Section: Shot – Results Of the First Yearsupporting

confidence: 84%

Systems Contributing to the Assurance of Transfusion Safety in the United Kingdom

Williamson

1999

Vox Sanguinis

View full text Add to dashboard Cite

In 1996, the United Kingdom launched a voluntary ‘haemovigilance’ system for confidential reporting of transfusion–related deaths and major adverse events. The Serious Hazards of Transfusion (SHOT) initiative provided the first comprehensive overview of transfusion safety in the UK, with 12 fatalities reported in the first year. The most important finding was that of a total of 169 reports, 47% were ‘wrong blood to patient’ episodes, of which 16 were ABO–incompatible. There were eight transfusion–transmitted infections, three bacterial, four viral and one malarial. A number of other initiatives exist in the UK which also have importance in contributing to transfusion safety. This article reviews these other key contributors, allowing SHOT to be placed in context.

show abstract

Section: Shot – Results Of the First Yearsupporting

confidence: 84%

Systems Contributing to the Assurance of Transfusion Safety in the United Kingdom

Williamson

1999

Vox Sanguinis

View full text Add to dashboard Cite

show abstract

“…The polyester fibers of the leukocyte reduction filters manufactured using a negatively charged surface result in an increased amount of bradykinin generated by the activation of the contact system of coagulation factors (factor XII, prekallikrein, and high-molecular weight kininogen) [8]. Bradykinin levels in platelet components reached a maximum at 5–10 min after filtration through the negatively charged filters and prekallikrein levels decreased by about 10% (indicating activation of the contact system).…”

Section: Discussionmentioning

confidence: 99%

Hypotensive Reactions Associated with Platelet Transfusions and Angiotensin-Converting Enzyme Inhibitors

Mair

Leparc

1998

Vox Sanguinis

View full text Add to dashboard Cite

Background and Objectives: To determine the cause of hypotensive reactions associated with platelet transfusions in coronary artery bypass surgery patients. Materials and Methods: Platelet transfusion reactions that occurred during a 3-month period were retrospectively reviewed. Results: Eighteen transfusion reactions occurred in 16 patients. Sixteen of the reactions were hypotensive, and occurred in 14 patients transfused with platelets through negatively charged bedside leukocyte reduction filters. All 14 patients had received angiotensin-converting enzyme (ACE) inhibitors prior to transfusion. Conclusion: Preliminary findings suggest a new type of transfusion reaction associated with the use of negatively charged leukocyte reduction filters during platelet transfusions to patients on ACE inhibitors.

show abstract

“…3 In the past, contact system activation was attributed to bedside leukoreduction. [3][4][5][6]17 However, all patients in our study received blood products that were leukoreduced prior to storage. As such, the generation of bradykinin could not have been attributable to leukocyte filtration in these cases.…”

Section: Commentmentioning

confidence: 99%

The Development of a Novel Molecular Assay Examining the Role of Aminopeptidase P Polymorphisms in Acute Hypotensive Transfusion Reactions

Hui

Tormey

2013

Archives of Pathology &Amp; Laboratory Medicine

View full text Add to dashboard Cite

N Context.-Acute hypotensive transfusion reactions are potentially harmful adverse effects of transfusion attributable to bradykinin generation. They are most often seen in patients taking angiotensin-converting enzyme (ACE) inhibitors (ACE-Is) because of the role ACE plays in metabolizing bradykinin. However, a number of acute hypotensive transfusion reactions occur in patients not taking ACE-Is. Aminopeptidase P (APP), another important enzyme responsible for bradykinin degradation, is encoded by the polymorphic XPNPEP2 gene. Some polymorphisms in XPNPEP2 have been associated with decreased APP activity. However, the role that APP polymorphisms play in acute hypotensive transfusion reactions has never been investigated.Objective.-To develop a molecular assay to examine for the C-2399A single-nucleotide polymorphism (SNP) in the APP gene, XPNPEP2, in patients experiencing acute hypotensive transfusion reactions unassociated with ACEIs.Design.-We developed an assay using polymerase chain reaction and DNA sequencing with primers targeted at XPNPEP2 (59-GAGTATTATGTGGGGACCATCC-39 and 59-ATGCCTCGCAGAGACAAGAG-39). Polymorphism zygosity was determined by comparing the sense/antisense sequencing results. This assay was then applied to patients with acute hypotensive transfusion reactions not taking ACE-Is (n = 4).Results.-A C-2399A SNP assay was successfully developed and applied to patients with acute hypotensive transfusion reactions. In a pilot study, 2 patients (50%) were found to possess C-2399A polymorphisms. One was found to be homozygous, and the other was heterozygous.Conclusions.-Our C-2399A SNP assay can be used to study acute hypotensive transfusion reactions in patients not taking ACE-Is. Initial data indicate that the C-2399A polymorphism may be a contributing factor in such reactions. However, further studies are necessary to better define the role of APP polymorphisms in relation to acute hypotensive transfusion reactions unassociated with ACEIs.(Arch Pathol Lab Med. 2013;137:96-99; doi: 10.5858/ arpa.2011-0466-OA) A cute hypotensive transfusion reactions are relatively rare, but potentially serious adverse events in which a transfusion recipient manifests a marked decrease in blood pressure with a virtual absence of other signs and symptoms.1,2 Much of the pathophysiology of acute hypotensive transfusion reactions has been linked to bradykinins and their metabolites, mediators that can induce substantial vasodilation and smooth muscle relaxation in vivo, with a resultant decrease in blood pressure.3 Some studies have also shown that bradykinin accumulation and hypotensive episodes may be exacerbated in transfused patients taking angiotensin-converting enzyme (ACE) inhibitors (ACE-Is), because ACE is a key enzyme in the degradation of bradykinin.3-11 However, based on reports of acute hypotensive transfusion reactions occurring in the absence of ACE-I use, 5,12 it is possible that other pathways may contribute to the accumulation of bradykinin and/or their metabolites and result in hypotension in the se...

show abstract

Activation of the contact system by filtration of platelet concentrates with a negatively charged white cell‐removal filter and measurement of venous blood bradykinin level in patients who received filtered platelets

Abstract: These results suggest that the generation of a large amount of bradykinin by filtration of PCs through a negatively charged filter might cause hypotensive reactions in patients with decreased ACE activity. The clinical significance of bradykinin generation requires further study.

Cited by 92 publications

References 15 publications

Systems Contributing to the Assurance of Transfusion Safety in the United Kingdom

Systems Contributing to the Assurance of Transfusion Safety in the United Kingdom

Hypotensive Reactions Associated with Platelet Transfusions and Angiotensin-Converting Enzyme Inhibitors

The Development of a Novel Molecular Assay Examining the Role of Aminopeptidase P Polymorphisms in Acute Hypotensive Transfusion Reactions

Contact Info

Product

Resources

About