Abstract
Objective: Several Western European countries and Canada have introduced white blood cell reduction as a universal standard to prevent potential adverse effects of allogeneic blood transfusions. However, there is an ongoing controversy regarding its appropriateness in other countries such as North America. We were interested in the whereabouts of leukocytes following whole blood transfusion in mice to evaluate their potential sites of (adverse) action. Materials and methods: Wildtype C57BL/6 were transfused with non-leukoreduced blood from enhanced green fluorescent protein transgenic C57BL/6-Tg(CAGEGFP) 1 Osb/J mice. Cells were tracked on day 3 and day 5 after transfusion by flow cytometry. Results: Enhanced green fluorescent protein-labeled leukocytes were found in the blood circulation, the myocardium, bone marrow and lung tissue up until day 5, but not in the kidney, the liver or the spleen. Myeloperoxidase activity in the lungs was significantly higher on day 5 when compared to control animals (0.09 ± 0.01% vs. 0.26 ± 0.08%, p=0.047). There was no increase in cytokines. Conclusion: Syngeneic white blood cells survive in the recipient of non-leukoreduced red blood cell units. They circulate in the blood stream and can be found in the bone marrow and the lungs up to five days after transfusion.
Highlights
Red Blood Cell (RBC) transfusions are used worldwide as a lifesaving procedure in many health care settings
Enhanced green fluorescent protein-labeled leukocytes were found in the blood circulation, the myocardium, bone marrow and lung tissue up until day 5, but not in the kidney, the liver or the spleen
Syngeneic white blood cells survive in the recipient of non-leukoreduced red blood cell units
Summary
Red Blood Cell (RBC) transfusions are used worldwide as a lifesaving procedure in many health care settings. Several Western European countries and Canada have introduced white blood cell (WBC) reduction as a universal standard to prevent potential adverse effects of allogeneic blood transfusions. The U.S Food and Drug Administration (FDA) supports the use of leukocytes reduced blood [5], but leukoreduction has not been fully implemented by all blood establishments. This in vivo study examines where syngeneic leukocytes can be found in the recipient after transfusion of nonleukoreduced blood in a time-dependent murine model in order to provide further insights into potential mechanisms of WBC-associated adverse events
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