The Expression of CD47 and Its Association with Other Biochemical Storage Lesions in Stored Non-Leucoreduced versus Leucoreduced Red Blood Cell Units

Abstract

Abstract Background The emergent need for blood transfusion required blood storage at low temperature which induced biochemical and biomechanical changes, collectively known as RCSL(red cell storage lesion). CD47 is an integrin associated protein which decreases with PRBCs(packed red blood cells) prolonged storage that possibly leads to less effective blood transfusion. Electrolyte imbalance occurs due to inactivation of Na+/K+ ATPase pump in low temperature which inturn leads to continuous increase of extracellular potassium which is considered life threatening for patients with renal failure or those with massive transfusions. Aim of the Work The aim of our study is to Evaluate the expression of CD47 by flow cytometry with other biochemical storage changes (pH, sodium and potassium ions) in CPD/SAGM packed non-leucoreduced Group(A) versus CPD/SAGM leucoreduced Group(B) red blood cell units at different storage times (on day 7, 14, 28 from date of red blood cells collection). Subjects and Methods 450 ml of whole blood is obtained into Quadruple blood bags and further subdivided into 20 non-leucoreduced units and 20 leucoreduced units. Non-leucoreduced and leucoreduced units are stored at 4 ± 2◦C. Samples are taken from each packed red blood cell unit at days 7,14 and 28 and tested for (Na+&K+) ions, pH and CD47 marker by flow cytometry. Results Both leucoreduced and non-leucoreduced units show a highly significant decrease in sodium, pH and CD47 expression and a highly significant increase in potassium level. However, there was no statistically significant difference found between 2 studied groups regarding sodium & potassium level, pH and CD47 expression on packed red cells except for sodium on 28th day which was slightly higher in leucoredced than non-leucoreduced units. Conclusion Red cell storage lesion is an inevitable process. Our study showed a highly statistically significant decrease in CD47 by flow cytometry in both leucoreduced and non-leucoreduced PRBCs along the storage period from day 7 to day 28. Red cell concentrates show significant decrease in sodium and pH and increase in the level of potassium during storage. Unlike many other studies, leucoreduction didn’t affect the expression of neither CD47 nor biochemical parameters (Na, K and pH) from day 7 to day 28 of PRBc storage.