Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Shock. 2018 May;49(5):514-521. doi: 10.1097/SHK.0000000000000972.
Effects of blood transfusions on platelet- and leukocyte-related inflammation are unclear. We simulated transfusion using in vitro blood mixing to evaluate platelet-leukocyte aggregations (PLA) and platelet P-selectin expression, and the mechanism of PLA. Donor packed red blood cells (pRBCs) were obtained from a blood bank. Recipient whole blood samples were obtained from patients undergoing cardiac surgery. Blood sample mixtures were divided into four groups: group M, cross-matched blood type mixing; group O, donor type O with other blood type mixing (A, B, or AB); group S, ABO type-specific uncross-matched blood mixing; and group I, ABO incompatibility mixing. Donor pRBCs were added to recipient blood to reach 1%, 5%, and 10% (vol/vol) concentrations. Blood sample mixtures were analyzed to determine the PLA; P-selectin expression; and leukocyte CD11a, CD11b, and CD18 subunits of integrin expression. Analysis of variance tests were used to analyze differences. PLA significantly increased only in groups O and I (P = 0.003 and P < 0.001). Subpopulations of leukocytes significantly increased in all groups. There were no significant differences among the four groups (P = 0.578) in PLA increase. Although there was no significant effect on P-selectin expression (P = 1.000) and leukocyte CD11a and CD18 expression (P = 0.999, P = 0.422) within and between the groups, there was an increase in CD11b expression (P = 0.018). Blood mixing can increase PLA, especially in platelet-neutrophil and platelet-monocyte aggregations, possibly through nonhemolytic reactions. The CD11b integrin with CD18 may play a role in the formation of PLA.
输血对血小板和白细胞相关炎症的影响尚不清楚。我们通过体外血液混合模拟输血，以评估血小板-白细胞聚集（PLA）和血小板 P 选择素表达，以及 PLA 的机制。供体浓缩红细胞（pRBC）来自血库。受体全血样本取自接受心脏手术的患者。血液样本混合物分为四组：M 组，交叉配血混合；O 组，O 型供体与其他血型（A、B 或 AB）混合；S 组，ABO 型特异性非交叉配血混合；I 组，ABO 不合混合。将供体 pRBC 加入受体血液中，浓度分别为 1%、5%和 10%（体积/体积）。分析血液样本混合物以确定 PLA；P 选择素表达；白细胞整合素 CD11a、CD11b 和 CD18 亚基的表达。方差分析用于分析差异。仅在 O 组和 I 组 PLA 显著增加（P=0.003 和 P<0.001）。所有组的白细胞亚群均显著增加。四组之间 PLA 增加无显著差异（P=0.578）。尽管 P 选择素表达（P=1.000）和白细胞 CD11a 和 CD18 表达（P=0.999，P=0.422）在组内和组间无显著影响，但 CD11b 表达增加（P=0.018）。血液混合可增加 PLA，尤其是血小板-中性粒细胞和血小板-单核细胞聚集，可能通过非溶血性反应。CD11b 整合素与 CD18 可能在 PLA 形成中起作用。
