Chang Chih-Chun, Lee Tai-Chen, Su Ming-Jang, Lin Hsiu-Chen, Cheng Fang-Yi, Chen Yi-Ting, Yen Tzung-Hai, Chu Fang-Yeh
Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan.
Department of Nephrology and Division of Clinical Toxicology and Toxicology Laboratory, Chang Gung Memorial Hospital, Lin-Kou Medical Center, Taoyuan, Taiwan.
Oncotarget. 2017 Dec 7;9(4):4385-4394. doi: 10.18632/oncotarget.23136. eCollection 2018 Jan 12.
Leukoreduction in blood units could prevent patients undergoing transfusions from transfusion-associated adverse reactions (TAARs) such as febrile nonhemolytic transfusion reactions (FNHTRs). However, the effect of prestorage and poststorage leukoreduction on TAARs and its underlying mechanisms in stored blood components remains to be determined. Therefore, we investigated the impact of prestorage leukocyte-reduced (pre-LR) and poststorage leukocyte-reduced (post-LR) blood products, including red blood cells (RBCs) and apheresis platelets (PHs), on the incidence of FNHTRs and other TAARs in patients who received transfusions from 2009 to 2014 in a tertiary care center. We also investigated the difference of leukocyte-related bioactive mediators between pre- and post-LR blood components. The results indicated that prevalence of TAARs was significantly reduced in the transfusions of pre-LR blood components. Particularly, the prevalence of FNHTRs was significantly reduced in the pre-LR RBC transfusions and the prevalence of allergy reactions was markedly reduced in the pre-LR PH transfusions. Furthermore, evaluation of cytokines in the pre- and post-LR blood components revealed that IL-1β, IL-8 and RANTES levels were significantly elevated in the post-LR RBCs during the storage. In contrast, IL-1β, IL-6 and IL-8 levels were significantly elevated in the post-LR PHs during the storage. These findings suggested that prestorage leukoreduction had a diminishing effect on the development of TAARs, which could be associated with less accumulation of cytokines in the stored blood components.
对血液单位进行白细胞滤除可防止接受输血的患者发生输血相关不良反应(TAARs),如发热性非溶血性输血反应(FNHTRs)。然而,储存前和储存后白细胞滤除对储存血液成分中TAARs的影响及其潜在机制仍有待确定。因此,我们调查了2009年至2014年在一家三级医疗中心接受输血的患者中,储存前白细胞滤除(pre-LR)和储存后白细胞滤除(post-LR)的血液制品,包括红细胞(RBCs)和单采血小板(PHs),对FNHTRs及其他TAARs发生率的影响。我们还研究了pre-LR和post-LR血液成分之间白细胞相关生物活性介质的差异。结果表明,pre-LR血液成分输血中TAARs的发生率显著降低。特别是,pre-LR红细胞输血中FNHTRs的发生率显著降低,pre-LR血小板输血中过敏反应的发生率显著降低。此外,对pre-LR和post-LR血液成分中的细胞因子进行评估发现,储存期间post-LR红细胞中IL-1β、IL-8和RANTES水平显著升高。相比之下,储存期间post-LR血小板中IL-1β、IL-6和IL-8水平显著升高。这些发现表明,储存前白细胞滤除对TAARs的发生有减轻作用,这可能与储存血液成分中细胞因子积累较少有关。