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Evaluation of nonleukoreduced red blood cell transfusion units collected at delivery from the placenta

Authors

  • Line Widing,

    1. From the Departments of Pediatrics and Immunology & Transfusion Medicine and the Faculty Division Ullevål University Hospital, University of Oslo, Oslo, Norway.
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  • Anne Grete Bechensteen,

    1. From the Departments of Pediatrics and Immunology & Transfusion Medicine and the Faculty Division Ullevål University Hospital, University of Oslo, Oslo, Norway.
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  • Mohammad Reza Mirlashari,

    1. From the Departments of Pediatrics and Immunology & Transfusion Medicine and the Faculty Division Ullevål University Hospital, University of Oslo, Oslo, Norway.
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  • Annette Vetlesen,

    1. From the Departments of Pediatrics and Immunology & Transfusion Medicine and the Faculty Division Ullevål University Hospital, University of Oslo, Oslo, Norway.
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  • Jens Kjeldsen-Kragh

    1. From the Departments of Pediatrics and Immunology & Transfusion Medicine and the Faculty Division Ullevål University Hospital, University of Oslo, Oslo, Norway.
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  • This study was supported by grant 554.30/02 from the Unexpected Child Death Society of Norway and by a grant from the Norwegian Research Council, both to AGB. We are also grateful to the Faculty of Medicine, University of Oslo, for supporting the project by providing a student grant to LW from June to August 2003.

Jens Kjeldsen-Kragh, MD, PhD, Consultant/Professor, Department of Immunology and Transfusion Medicine, Ullevål University Hospital, Kirkeveien 166, N-0407 Oslo, Norway; e-mail: jens.kjeldsen-kragh@medisin.uio.no.

Abstract

BACKGROUND: The objective of this study was to evaluate the suitability of cord blood (CB) as a source of red blood cells (RBCs) for autologous transfusion.

STUDY DESIGN AND METHODS: CB was collected in 150-mL storage containers with citrate phosphate dextrose (CPD) as anticoagulant and stored in either saline, adenine, glucose, and mannitol (SAG-M; n = 18) or phosphate, adenine, glucose, guanosine, saline, and mannitol (PAGGS-M; n = 18) for 35 days at 4°C. Hematologic status and hemolysis were studied. The lipopolysaccharide (LPS)-induced production of tumor necrosis factor (TNF)-α and transforming growth factor (TGF)-β1 from CB monocytes was analyzed after incubation with addition of weekly sampled supernatants from the CB RBC units. Five additional units (PAGGS-M) were leukoreduced and thereafter analyzed as indicated above.

RESULTS: Hemolysis increased significantly over time, in SAG-M more than in PAGGS-M. During storage in both media, the number of white blood cells (WBCs) decreased, and the LPS-induced production of TNF-α and TGF-β1 decreased and increased, respectively. There were no significant changes in the LPS-induced production of TNF-α and TGF-β1 in the leukoreduced CB RBC units.

CONCLUSION: Hemolysis in CB RBC units increased significantly over time, and PAGGS-M appears to be superior to SAG-M as a preservation solution for CB RBC. The changes in LPS-induced TNF-α and TGF-β1 production over time were probably caused by substances released from apoptotic and/or necrotic WBCs. Further studies are needed to identify both which substances are responsible for the changes in LPS-induced cytokine release and the clinical significance hereof.

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