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Transfusion of stored autologous blood does not alter reactive hyperemia index in healthy volunteers

Transfusion of stored autologous blood does not alter reactive hyperemia index in healthy volunteers
Transfusion of stored autologous blood does not alter reactive hyperemia index in healthy volunteers
Background: Transfusion of human blood stored for more than 2 weeks is associated with increased mortality and morbidity. During storage, packed erythrocytes progressively release hemoglobin, which avidly binds nitric oxide. We hypothesized that the nitric oxide mediated hyperemic response after ischemia would be reduced after transfusion of packed erythrocytes stored for 40 days.

Methods and results: We conducted a crossover randomized interventional study, enrolling 10 healthy adults. Nine volunteers completed the study. Each volunteer received one unit of 40-day and one of 3-day stored autologous leukoreduced packed erythrocytes, on different study days according to a randomization scheme. Blood withdrawal and reactive hyperemia index measurements were performed before and 10 min, 1 h, 2 h, and 4 h after transfusion. The reactive hyperemia index during the first 4 h after transfusion of 40-day compared with 3-day stored packed erythrocytes was unchanged. Plasma hemoglobin and bilirubin concentrations were higher after transfusion of 40-day than after 3-day stored packed erythrocytes (P = 0.02, [95% CI difference 10-114 mg/l] and 0.001, [95% CI difference 0.6-1.5 mg/dl], respectively). Plasma concentrations of potassium, lactate dehydrogenase, haptoglobin, and cytokines, as well as blood pressure, did not differ between the two transfusions and remained within the normal range. Plasma nitrite concentrations increased after transfusion of 40-day stored packed erythrocytes, but not after transfusion of 3-day stored packed erythrocytes (P = 0.01, [95% CI difference 0.446-0.66 ? M]).

Conclusions: Transfusion of autologous packed erythrocytes stored for 40 days is associated with increased hemolysis, an unchanged reactive hyperemia index, and increased concentrations of plasma nitrite.
0003-3022
56-63
Berra, Lorenzo
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Coppadoro, Andrea
d4a2f481-a4fa-4595-81a5-1b2beaefb4ac
Yu, Binglan
e1d2bb81-ec7d-475d-b459-fe1adc66fcde
Lei, Chong
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Spagnolli, Ester
c43f2755-b3da-44e0-955f-a5ecb5c94790
Steinbicker, Andrea U.
c6c31000-151e-4633-9542-a4b09db47b78
Bloch, Kenneth D.
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Lin, Tian
23f0cdac-82f4-4dc7-a399-8d51f113a5dc
Sammy, Fatima Y.
eef533d7-6875-4b1f-b817-d4bf16ac4758
Shaw Warren, H.
113209f0-4c69-44e0-b78a-a700484b0557
Fernandez, Bernadette O.
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Feelisch, Martin
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Dzik, Walter H.
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Stowell, Christopher P.
88c69410-d25e-437b-90fd-ee314bea5a77
Zapol, Warren M.
84efe66d-166f-4b1d-8db2-b48586aea27e
Berra, Lorenzo
f3f7e3e3-33d0-4857-aa47-f9c227f1e647
Coppadoro, Andrea
d4a2f481-a4fa-4595-81a5-1b2beaefb4ac
Yu, Binglan
e1d2bb81-ec7d-475d-b459-fe1adc66fcde
Lei, Chong
a97c9e5b-b936-4581-8a27-11591397b5f2
Spagnolli, Ester
c43f2755-b3da-44e0-955f-a5ecb5c94790
Steinbicker, Andrea U.
c6c31000-151e-4633-9542-a4b09db47b78
Bloch, Kenneth D.
25d43ddf-77d4-448b-b618-079a0492aba1
Lin, Tian
23f0cdac-82f4-4dc7-a399-8d51f113a5dc
Sammy, Fatima Y.
eef533d7-6875-4b1f-b817-d4bf16ac4758
Shaw Warren, H.
113209f0-4c69-44e0-b78a-a700484b0557
Fernandez, Bernadette O.
27babc73-7646-4908-86e2-6c29d79fb938
Feelisch, Martin
8c1b9965-8614-4e85-b2c6-458a2e17eafd
Dzik, Walter H.
3442203a-91f0-4580-8606-403b20fc1c4f
Stowell, Christopher P.
88c69410-d25e-437b-90fd-ee314bea5a77
Zapol, Warren M.
84efe66d-166f-4b1d-8db2-b48586aea27e

Berra, Lorenzo, Coppadoro, Andrea, Yu, Binglan, Lei, Chong, Spagnolli, Ester, Steinbicker, Andrea U., Bloch, Kenneth D., Lin, Tian, Sammy, Fatima Y., Shaw Warren, H., Fernandez, Bernadette O., Feelisch, Martin, Dzik, Walter H., Stowell, Christopher P. and Zapol, Warren M. (2012) Transfusion of stored autologous blood does not alter reactive hyperemia index in healthy volunteers. Anesthesiology, 117 (1), 56-63. (doi:10.1097/ALN.0b013e31825575e6). (PMID:22531338)

Record type: Article

Abstract

Background: Transfusion of human blood stored for more than 2 weeks is associated with increased mortality and morbidity. During storage, packed erythrocytes progressively release hemoglobin, which avidly binds nitric oxide. We hypothesized that the nitric oxide mediated hyperemic response after ischemia would be reduced after transfusion of packed erythrocytes stored for 40 days.

Methods and results: We conducted a crossover randomized interventional study, enrolling 10 healthy adults. Nine volunteers completed the study. Each volunteer received one unit of 40-day and one of 3-day stored autologous leukoreduced packed erythrocytes, on different study days according to a randomization scheme. Blood withdrawal and reactive hyperemia index measurements were performed before and 10 min, 1 h, 2 h, and 4 h after transfusion. The reactive hyperemia index during the first 4 h after transfusion of 40-day compared with 3-day stored packed erythrocytes was unchanged. Plasma hemoglobin and bilirubin concentrations were higher after transfusion of 40-day than after 3-day stored packed erythrocytes (P = 0.02, [95% CI difference 10-114 mg/l] and 0.001, [95% CI difference 0.6-1.5 mg/dl], respectively). Plasma concentrations of potassium, lactate dehydrogenase, haptoglobin, and cytokines, as well as blood pressure, did not differ between the two transfusions and remained within the normal range. Plasma nitrite concentrations increased after transfusion of 40-day stored packed erythrocytes, but not after transfusion of 3-day stored packed erythrocytes (P = 0.01, [95% CI difference 0.446-0.66 ? M]).

Conclusions: Transfusion of autologous packed erythrocytes stored for 40 days is associated with increased hemolysis, an unchanged reactive hyperemia index, and increased concentrations of plasma nitrite.

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e-pub ahead of print date: 23 April 2012
Published date: July 2012
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 337689
URI: https://eprints.soton.ac.uk/id/eprint/337689
ISSN: 0003-3022
PURE UUID: 454304b1-f3ab-43b5-9118-3dc676252044
ORCID for Martin Feelisch: ORCID iD orcid.org/0000-0003-2320-1158

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Date deposited: 02 May 2012 11:47
Last modified: 29 Oct 2019 01:40

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Contributors

Author: Lorenzo Berra
Author: Andrea Coppadoro
Author: Binglan Yu
Author: Chong Lei
Author: Ester Spagnolli
Author: Andrea U. Steinbicker
Author: Kenneth D. Bloch
Author: Tian Lin
Author: Fatima Y. Sammy
Author: H. Shaw Warren
Author: Bernadette O. Fernandez
Author: Martin Feelisch ORCID iD
Author: Walter H. Dzik
Author: Christopher P. Stowell
Author: Warren M. Zapol

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