Abstract

Simple SummaryDuring the storage of blood units, cells undergo many changes, defined as storage lesions; these are biochemical, morphological and immunological modifications and seem to be responsible for adverse post-transfusion effects in recipients. The pre-storage leukoreduction seems to reduce them. The aims of this study are both to evaluate the human filter effectiveness and the effect of pre-storage leukoreduction in stored canine whole blood units. We tested whole blood units, leukoreduced and not, obtained from seven enrolled subjects, until the 42nd day. The white blood cell (WBC) and platelet (PLT) counts are reported to express the leukoreduction effectiveness. As indicators of storage-induced hemolysis, the lactate dehydrogenase activity (LDH) and sodium, potassium, and chlorine electrolytes were measured in plasma, and the red blood cell (RBC) count, hemoglobin concentration (Hgb), and hematocrit (Hct) were obtained with the complete blood count (CBC). The mean corpuscular volume (MCV) values and morphological index obtained from blood smear evaluation were used as indices of morphological changes. We observed that the leukoreduction filter for human use is equally effective on canine whole blood and that leukoreduction has a partially protective role to prevent some storage lesions.Storage lesions (SLs) occur when the red blood cell quality is altered during the preservation of blood units. Pre-storage leukoreduction would limit the number of SLs. The aims of this study were to evaluate the effectiveness of a leukoreduction filter for human use and the effect of pre-storage leukoreduction on some ematobiochemical parameters in stored canine whole blood. Seven canine blood units were tested. Each one was divided into two units—one leukoreduced (LRWB) and one non-leukoreduced (nLRWB). On each unit, we determined the complete blood count (CBC), lactate-dehydrogenase (LDH), electrolytes (Na+, K+, Cl−), morphological index (MI) and hemolysis, on storage days 0, 7, 14, 21, 28, 35, and 42. Leukoreduction allowed a 98.30% recovery of the RBC count, retaining 99.69% and 94.91% of WBCs and PLTs, respectively. We detected a significant increase of LDH and MI with strongly higher values in nLRWB compared to LRWB. A progressive increase in electrolytes and LDH concentrations was observed as indices of stored hemolysis. LDH showed significantly lower values in LRWB units compared to nLRWB, suggesting its release from leukocytes. In the majority of units, hemolysis reached 1% on the 42nd day of storage. We assert the human leukoreduction filter effectiveness on canine whole blood, and we recommend using nLRWB before day 14, especially for critically ill patients. The difference of the basal hemolysis (day 0) percentages observed between subjects suggests that more studies should be performed to confirm a possible inter-individual donor biological variability of RBC membrane resistance, as happens in humans.

Highlights

  • Blood transfusion represents an essential therapeutic intervention in some hematological diseases and in emergency critical care

  • Blood bags can be stored for a period of time between 35 and 42 days depending on the product [2,3]

  • Based on the results of our study, we believe that the leukoreduction filter for human use is effective on canine whole blood units as it allowed a 98.30% recovery of red blood cells (RBCs), retaining 99.69% and 94.91% of white blood cells (WBCs) and PLTs, respectively

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Summary

Introduction

Blood transfusion represents an essential therapeutic intervention in some hematological diseases and in emergency critical care. The modifications related to the corpuscular components of blood units could relate to RBC, white blood cells (WBCs) and platelets (PLTs) Those related to RBCs are oxidative injury [7], hemolysis [2,6], morphological alterations and changes in membrane composition [1], changes in sodium and potassium levels [1,5,8], and the release of procoagulant microparticles [9,10]; those connected to WBCs and PLTs are the increase in interleukin (Il-8) and VEGF [11,12,13], and the release of procoagulant phospholipid (PPL) [14] and microparticles [15]

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