Department of Pathology and Cell Biology, Columbia University Medical Center and New York-Presbyterian Hospital, New York, New York, USA.
Transfusion. 2011 Apr;51(4):881-5. doi: 10.1111/j.1537-2995.2011.03096.x.
Retrospective studies suggest that the transfusion of older, stored red blood cells (RBCs) may be associated with increases in mortality, serious infections, multiorgan failure, thrombosis, and hospital length of stay. Our research is based on the overarching hypothesis that the adverse effects associated with transfusion of older, stored RBCs result from the acute delivery of hemoglobin iron to the monocyte-macrophage system. To test this "iron hypothesis," we are recruiting healthy human volunteers to donate double, leukoreduced, RBC units. We then transfuse them with one autologous fresh unit (i.e., after 3-7 days of storage) and one older, stored unit (i.e., at 40-42 days of storage). The primary study outcome will compare laboratory iron measures and proinflammatory cytokines after transfusion of fresh or older, stored RBCs. Similar studies using allogeneic RBC transfusions will be performed in chronically transfused patients with either sickle cell disease or β-thalassemia. Although prospective, randomized studies will ultimately determine the existence of adverse effects from transfusing older, stored RBCs, our goal is to determine the mechanism(s) for this potential effect.
回顾性研究表明，输注较陈旧、储存时间较长的红细胞（RBC）可能与死亡率增加、严重感染、多器官衰竭、血栓形成和住院时间延长有关。我们的研究基于一个总体假设，即输注较陈旧、储存时间较长的 RBC 所带来的不良影响是由于血红蛋白铁的急性递送至单核细胞-巨噬细胞系统。为了验证这一“铁假说”，我们正在招募健康的人类志愿者捐献双倍、白细胞减少的 RBC 单位。然后，我们用一个自身新鲜单位（即储存 3-7 天后）和一个较陈旧、储存的单位（即储存 40-42 天后）对他们进行输血。主要研究结果将比较新鲜或较陈旧、储存的 RBC 输血后实验室铁指标和促炎细胞因子。在患有镰状细胞病或β地中海贫血的慢性输血患者中，将进行类似的使用同种异体 RBC 输血的研究。尽管前瞻性、随机研究最终将确定输注较陈旧、储存的 RBC 所带来的不良影响的存在，但我们的目标是确定这种潜在影响的机制。
