Impact of red blood cell transfusion on platelet activation and aggregation in healthy volunteers: results of the TRANSFUSION study.
نویسندگان
چکیده
AIMS The underlying mechanisms leading to recurrent ischaemic events or mortality after red blood cell (RBC) transfusion in anaemic acute coronary syndrome patients are poorly understood. The aim of this paper is to determine whether RBC transfusion increases platelet activation and aggregation. METHODS AND RESULTS In vitro transfusions (n = 45) were performed by the addition of RBCs obtained from transfusion packs to fresh whole blood provided by healthy volunteers. Residual platelet aggregation (RPA) and maximal platelet aggregation (MPA) were assessed before and after in vitro transfusion using light transmission aggregometry performed with four different agonists. Flow cytometry was used for the measurement of P-selectin expression and vasodilatator-stimulated phosphoprotein (VASP) platelet reactivity index (PRI). To control for the effect of haemoconcentration, the same experiments were repeated after hematocrit adjustment using volunteer's platelet poor plasma. Transfusion increased platelet aggregation as measured by RPA with ADP 5 µM (57.7 ± 25 vs. 65.7 ± 24%; P = 0.03) or Collagen 2 µg/mL (59.4 ± 28 vs. 69.7 ± 24%; P = 0.03). There were no significant differences with Arachidonic Acid 1.25 mM or Epinephrine 20 µM and results were similar when MPA was considered. Platelet activation was also increased by transfusion as confirmed by an elevation of P-selectin expression induced by 20 µM ADP (12.2 ± 18 vs. 23.9 ± 18%; P = 0.002) or 50 µM ADP (15.4 ± 18.6 vs.26.8 ± 21.2%; P = 0.004) and an increase in VASP PRI (77.8 ± 6 vs. 81.9 ± 3%; P = 0.03). These effects were all independent of hematocrit. CONCLUSION Red blood cell transfusion increases platelet activation and aggregation in vitro in healthy volunteers. This effect might be mediated through the P2Y(12) activation pathway.
منابع مشابه
Perioperative changes in platelet count and function in patients undergoing cardiac surgery
Background: Patients undergoing cardiac surgery are at increased risk of bleeding due to multifactorial coagulopathies. In the present study, we aimed at investigating the changes in platelet count and function during and after surgery as well as determining the association of the platelet dysfunction with bleeding and transfusion requirements in these patients. Methods: A total o...
متن کاملAn Overview on Platelet-derived Microparticles in Platelet Concentrates: blood collection, method preparation and storage
Preparations of platelet concentrates (PCs) that are stored under blood bank conditions and used for transfusion purposes, appear to be enriched in platelet derived-microparticles (PMPs) with high coagulant activity that may change platelet efficacy and safety issues. High shear stress could cause shedding of PMPs from the platelet plasma membrane, platelet aggregation, and activation of the co...
متن کاملEvaluation of Blood Storage Lesions in Leuko-depleted Red Blood Cell Units
Background: Red blood cells (RBCs) undergo biochemical and morphologic alterations during storage that are known as the storage lesions causing decreased RBC quality and are correlated with transfusion reactions in certain groups especially in infants and critically ill patients. Microvesicles (MVs) as one of storage lesions may be derived from various cell types and have key roles in several...
متن کاملPrevalence of Alloantibodies and Autoantibodies in Transfusion Dependent Thalassemia Patients
Background: The development of anti-red blood cell alloantibodies remains a major problem in transfusion of blood in thalassemia major patients. Also, Autoantibodies can result in clinical hemolysis and difficulty in cross-matching blood. We studied the frequency of red blood cell alloimmunization and autoimmunization among thalassemia patients who received regular transfusions in Ilam province...
متن کاملAllogeneic Red Blood Cell Transfusion Following the Total Hip Arthroplasty Triggers the Immunomodulatory Responses
Background and Aims: Total hip arthroplasty (THA) is a common orthopedic surgery. The main focus in the research of THA is immune responses in these patients following the blood transfusion.Therefore, in this study, we evaluated the immune modulation indexes such as T cell amplification, Tcell surface markers and also production of cytokines in the patients undergoing THA surgery following bloo...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- European heart journal
دوره 31 22 شماره
صفحات -
تاریخ انتشار 2010