From the Division of Trauma, Department of Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey.
J Trauma Acute Care Surg. 2013 Dec;75(6):984-9. doi: 10.1097/TA.0b013e31829530c7.
Following trauma, transfusion of aged stored blood is often necessary yet associated with increased morbidity and mortality. Despite blood replacement, many patients have a prolonged anemia requiring further transfusions. The effects of aged blood on bone marrow (BM) hematopoiesis have not been studied, and we hypothesized that stored blood suppresses BM function.
Blood from Sprague-Dawley rats was stored for 1, 14, or 28 days with the industry preservative citrate-phosphate-dextrose-adenine-1 (CPDA-1). For in vitro studies, 5% supernatant was incubated with normal rat BM and cultured for erythroid (CFU-E) and granulocyte-macrophage (CFU-GM) colony-forming units. Data were compared with cultures of BM alone, 5% control plasma (negative control), and 12% CPDA-1. For in vivo studies, rats were transfused with stored supernatants (5% estimated blood volume (EBV) over 30 minutes). BM from each recipient was cultured for CFU-E and CFU-GM at 3 hours after transfusion. Data were compared with cultures of BM alone. Difference between groups determined by analysis of variance and Tukey's multiple comparison test.
In vitro exposure to CPDA-1, control plasma, or 1-day supernatant (D1) had no effect on BM growth compared with BM alone. In vitro exposure to 14-day (D14) and 28-day (D28) supernatant significantly suppressed CFU-E by 60% and CFU-GM growth by 71% (both p < 0.05) compared with D1 or medial alone. There were no differences between D14 and D28. In vivo exposure to D14 reduced BM CFU-E and CFU-GM growth by 55% (both p < 0.05) compared with D1 supernatant.
Plasma from aged blood adversely affects CFU-E and CFU-GM growth in rats. The effect is not mediated by CPDA-1. Transfusion of aged stored blood may contribute to BM dysfunction in critically ill patients, resulting in persistent anemia and the need for further transfusion. This BM dysfunction may also partly explain the observed increased susceptibility to infection.
创伤后，经常需要输注陈旧储存的血液，但这与发病率和死亡率的增加有关。尽管进行了血液替代，但许多患者仍存在长期贫血，需要进一步输血。陈旧血液对骨髓（BM）造血功能的影响尚未得到研究，我们假设储存的血液会抑制 BM 功能。
将来自 Sprague-Dawley 大鼠的血液用工业防腐剂柠檬酸盐-磷酸盐-葡萄糖-腺嘌呤-1（CPDA-1）储存 1、14 或 28 天。对于体外研究，将 5%上清液与正常大鼠 BM 孵育，并培养红细胞（CFU-E）和粒细胞-巨噬细胞（CFU-GM）集落形成单位。将数据与单独的 BM 培养物、5%对照血浆（阴性对照）和 12%CPDA-1 进行比较。对于体内研究，大鼠在 30 分钟内输注储存的上清液（估计 5%血液体积（EBV））。在输血后 3 小时，从每个受者的 BM 中培养 CFU-E 和 CFU-GM。将数据与单独的 BM 培养物进行比较。通过方差分析和 Tukey 多重比较检验确定组间差异。
与单独的 BM 相比，体外暴露于 CPDA-1、对照血浆或 1 天上清液（D1）对 BM 生长没有影响。与 D1 或中位数相比，体外暴露于 14 天（D14）和 28 天（D28）上清液显著抑制 CFU-E 生长 60%，抑制 CFU-GM 生长 71%（均 p <0.05）。D14 和 D28 之间没有差异。与 D1 上清液相比，体内暴露于 D14 使 BM CFU-E 和 CFU-GM 生长减少 55%（均 p <0.05）。
陈旧血液的血浆会对大鼠 CFU-E 和 CFU-GM 的生长产生不利影响。这种作用不是由 CPDA-1 介导的。输注陈旧储存的血液可能导致危重病患者的 BM 功能障碍，导致持续贫血和需要进一步输血。这种 BM 功能障碍也可能部分解释了观察到的易感染性增加。
