Alteration of red cell aggregability and shape during blood storage

Hovav, Tavor; Yedgar, Saul; Manny, Noga; Barshtein, Gregory

doi:10.1046/j.1537-2995.1999.39399219284.x

Cited by 160 publications

(138 citation statements)

References 22 publications

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“…6,[16][17][18] The coadministration of toxic substances that accumulated in the storage supernatant including microparticles, lipophosphatidylcholines, cytokines, free hemoglobin, and iron may promote inflammatory response and oxidative stress and contribute to organ tissue dysfunction in transfused patients. [19][20][21][22][23][24] AKI is a common adverse event after PCI and is associated with increased morbidity and mortality and health care costs.…”

Section: Discussionmentioning

confidence: 99%

Blood Transfusion and the Risk of Acute Kidney Injury Among Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

Karrowni

Vora

Dai

et al. 2016

Circ: Cardiovascular Interventions

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A cute kidney injury (AKI) is one of the most common adverse events after percutaneous coronary intervention (PCI) and is of prognostic significance.1,2 Risk factors for its development have been the focus of multiple studies, and several patient-related and procedure-related factors have been identified. 3,4 However, no prior studies have considered the risks of periprocedural blood transfusion.There are many pathophysiological mechanisms by which blood transfusion might cause AKI, which are mainly related to impaired tissue oxygen delivery, and inflammation and oxidative stress. 5 Recently, blood transfusion has been identified as a risk factor for AKI in cardiac surgery 5,6 and in transcatheter aortic valve replacement. 7 Patients undergoing PCI are prone to bleeding given the invasive nature of the procedure and the use of antithrombotic and antiplatelet agents. Transfusion is relatively commonly used in these patients, and there is considerable variation in blood transfusion practices among patients undergoing PCI at the US hospitals. 8 The appropriate use of transfusion in this patient population might be influenced by its effect on AKI.Anemia is well-recognized as a risk factor for AKI, 9 and recently periprocedural bleeding in PCI patients was also identified to be associated with AKI. 10 However, the relationship between anemia, bleeding, and transfusion and the risk of AKI has not been well studied. Further characterization of this relationship and definition of other risk factors might help broaden prophylactic strategies against post-PCI AKI.In this cohort of patients with acute coronary syndrome (ACS) who underwent PCI, we aimed to (1) assess the association of blood transfusion with AKI and (2) characterize this relationship with anemia and bleeding. MethodsThe National Cardiovascular Data Registry (NCDR)-CathPCI Registry is the largest ongoing registry of PCI in the United States, Background-Acute kidney injury (AKI) complicating percutaneous coronary intervention (PCI) is associated with adverse clinical outcomes. To date, no studies have evaluated the association of blood transfusion with AKI in patients undergoing PCI. Methods and Results-We used a retrospective cohort study of all patients with acute coronary syndrome undergoing PCI from CathPCI Registry (n=1 756 864). The primary outcome was AKI defined as the rise in serum creatinine post procedure ≥0.5 mg/dL or ≥25% above baseline values. AKI developed in 9.0% of study sample. Patients with AKI were older, more often women, and had high prevalence of comorbidities, including diabetes mellitus, hypertension, and advanced stages of chronic kidney disease at baseline. Blood transfusion was utilized in 2.2% of patients. In the overall sample, AKI developed in 35.1% of patients who received transfusion versus 8.4% of patients without transfusion (adjusted odds ratio, 4.87 [4.71-5.04]). In the subgroup of patients who sustained bleeding event and received transfusion, the rate of AKI was significantly increased across all preprocedure hemoglobin...

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Section: Discussionmentioning

confidence: 99%

Blood Transfusion and the Risk of Acute Kidney Injury Among Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

Karrowni

Vora

Dai

et al. 2016

Circ: Cardiovascular Interventions

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“…19 Transfusion of stored RBCs also has been shown to induce tissue hypoxia in rodents. 20,21 Increased red cell aggregability 22 and rigidity, 23 the diminished microvascular autoregulatory abilities of stored red cells, 20,24 and the accumulation of potentially toxic microparticles, 25 lipophosphatidylcholines, 26 or proinflammatory cytokines 27 in the storage supernatant may all contribute to tissue hypoxia and organ dysfunction in transfused patients. Alternatively, systemic inflammation, a feature of the response to transfusion of nonleukodepleted red cells, 27 is implicated in atherosclerotic plaque rupture, stroke, and acute coronary syndromes.…”

Section: Findings In the Context Of The Literaturementioning

confidence: 99%

Increased Mortality, Postoperative Morbidity, and Cost After Red Blood Cell Transfusion in Patients Having Cardiac Surgery

et al. 2007

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Background-Red blood cell transfusion can both benefit and harm. To inform decisions about transfusion, we aimed to quantify associations of transfusion with clinical outcomes and cost in patients having cardiac surgery. Methods and Results-Clinical, hematology, and blood transfusion databases were linked with the UK population register.Additional hematocrit information was obtained from intensive care unit charts. Composite infection (respiratory or wound infection or septicemia) and ischemic outcomes (myocardial infarction, stroke, renal impairment, or failure) were prespecified as coprimary end points. Secondary outcomes were resource use, cost, and survival. Associations were estimated by regression modeling with adjustment for potential confounding.

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“…16,26,32,42,43 Evidence also indicates that CPB adversely affects RBC structure and function, [23][24][25] and one study has shown functional changes in salvaged autologous RBCs tested in vitro, but not in blood sampled from patients after salvaged blood transfusion. 44 In our study, we found that neither salvaged RBCs nor CPB, when studied in combination, had a detrimental effect on RBC deformability.…”

Section: Discussionmentioning

confidence: 99%

Impaired Red Blood Cell Deformability After Transfusion of Stored Allogeneic Blood But Not Autologous Salvaged Blood in Cardiac Surgery Patients

Salaria

Barodka

Hogue

et al. 2015

Survey of Anesthesiology

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Background-Both cardiopulmonary bypass (CPB) and red blood cell (RBC) storage are associated with detrimental changes in RBC structure and function that may adversely affect tissue oxygen delivery. We tested the hypothesis that in cardiac surgery patients, RBC deformability and aggregation are minimally affected by CPB with autologous salvaged blood alone, but are negatively affected by the addition of stored allogeneic blood.

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Alteration of red cell aggregability and shape during blood storage

Cited by 160 publications

References 22 publications

Blood Transfusion and the Risk of Acute Kidney Injury Among Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

Blood Transfusion and the Risk of Acute Kidney Injury Among Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

Increased Mortality, Postoperative Morbidity, and Cost After Red Blood Cell Transfusion in Patients Having Cardiac Surgery

Impaired Red Blood Cell Deformability After Transfusion of Stored Allogeneic Blood But Not Autologous Salvaged Blood in Cardiac Surgery Patients

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