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Research
Linsheng Zhan
Institute of Health Service and Transfusion Medicine
Corresponding Author
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BACKGROUND: Transfusion of stored whole blood (SWB) is increasingly routine practice to resuscitate severe traumatic hemorrhage patients in military operations and civilian emergency centers. It has been well established that transfusion of red blood cells (RBCs) after prolonged storage exerts harmful effects that are mainly mediated by inflammation. Whether the storage lesion that related to inflammation will happen in SWB remains unclear.
METHODS: A hepatocyte SAA (serum amyloid A) specific reporter mouse that facilitated non-invasive imaging of hepatocyte SAA expression was used for the evaluation of acute inflammation and acute-phase reaction after the transfusion of SWB or components separated from end-stage whole blood. Donor C57BL/6 mouse whole blood was used to model an allogeneic transfusion in Balb/C mouse recipients.
RESULTS: End-stage whole blood (14 days of storage) transfusion induced the most significant SAA expression, while 10-day-storage evoked much weaker signal compared to their fresh and 5-day-storage counterparts. It was RBCs rather than white blood cells and plasma-containing platelets that should be responsible for the systemic inflammatory and SAA activation during end-stage whole blood transfusion. Circulatory and hepatic pro-inflammatory cytokines induced the SAA expression in hepatocyte. The macrophage M1 polarization aroused by SWB activated SAA through nuclear transcription factor NF-κB.
CONCLUSION: Storage lesion will also happen during the storage of whole blood, which is related to the change of RBCs after prolonged storage. The side effect induced by systemic inflammation and acute-phase reaction should be taken into consideration before resuscitation by long-term storage whole blood transfusion.
Keywords
Whole blood, Dynamic Imaging, Serum Amyloid A, Inflammation.
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This is a preprint. It has not completed peer review.
Research
Linsheng Zhan
Institute of Health Service and Transfusion Medicine
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 17 Sep, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Economics & Outcomes Research
License:
This work is licensed under a CC BY 4.0 License. Read Full License
BACKGROUND: Transfusion of stored whole blood (SWB) is increasingly routine practice to resuscitate severe traumatic hemorrhage patients in military operations and civilian emergency centers. It has been well established that transfusion of red blood cells (RBCs) after prolonged storage exerts harmful effects that are mainly mediated by inflammation. Whether the storage lesion that related to inflammation will happen in SWB remains unclear.
METHODS: A hepatocyte SAA (serum amyloid A) specific reporter mouse that facilitated non-invasive imaging of hepatocyte SAA expression was used for the evaluation of acute inflammation and acute-phase reaction after the transfusion of SWB or components separated from end-stage whole blood. Donor C57BL/6 mouse whole blood was used to model an allogeneic transfusion in Balb/C mouse recipients.
RESULTS: End-stage whole blood (14 days of storage) transfusion induced the most significant SAA expression, while 10-day-storage evoked much weaker signal compared to their fresh and 5-day-storage counterparts. It was RBCs rather than white blood cells and plasma-containing platelets that should be responsible for the systemic inflammatory and SAA activation during end-stage whole blood transfusion. Circulatory and hepatic pro-inflammatory cytokines induced the SAA expression in hepatocyte. The macrophage M1 polarization aroused by SWB activated SAA through nuclear transcription factor NF-κB.
CONCLUSION: Storage lesion will also happen during the storage of whole blood, which is related to the change of RBCs after prolonged storage. The side effect induced by systemic inflammation and acute-phase reaction should be taken into consideration before resuscitation by long-term storage whole blood transfusion.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
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