Complement activation during storage of whole blood, red cells, plasma, and buffy coat.
BACKGROUND
The process of separating whole blood into components and the storage of blood components may cause the release of toxic metabolites from the complement cascade. The aim of this study was to determine whether the storage of blood components leads to the activation of the complement cascade and the release of anaphylatoxins.


METHODS
Blood from 12 healthy volunteers was collected and stored either as whole blood or as components: red cells in saline-adenine-glucose-mannitol solution, plasma, and buffy coat. The concentrations of anaphylatoxins and other complement proteins in the various blood components were intermittently analyzed during a 5-week storage period.


RESULTS
Increasing levels of anaphylatoxins were demonstrated during the storage of whole blood and plasma. Elevated concentrations of the anaphylatoxins C3a and C5a were observed during the storage of whole blood. Increased C5a levels were observed after 7 days of storage. High concentrations of C3a were found in plasma after 14 days of storage. Low or non-detectable levels of C3a; C5a, and other complement components were found in red cells stores in saline-adenine-glucose-mannitol solution.


CONCLUSIONS
The study demonstrated activation of complement during the storage of whole blood and plasma but not in red cells in storage solution. The transfusion of larger volumes of stored whole blood or plasma may contribute to the risk of development of organ dysfunction. Therefore, it is advisable to use red cells in storage solution.
Hyllner
M
M
Department of Anesthesiology, Sahlgrenska University Hospital, Goteborg, Sweden.
Arnestad
J P
JP
Bengtson
J P
JP
Rydberg
L
L
Bengtsson
A
A
D000706:Anaphylatoxins / Q000378:metabolism; D001793:Blood Preservation; D003167:Complement Activation; D003174:Complement C1 Inactivator Proteins / Q000032:analysis; D003176:Complement C3 / Q000032:analysis; D015926:Complement C3a / Q000032:analysis; D003181:Complement C4 / Q000032:analysis; D003182:Complement C5 / Q000032:analysis; D015936:Complement C5a / Q000032:analysis; D015937:Complement C5a, des-Arginine / Q000032:analysis; D015938:Complement Membrane Attack Complex; D003165:Complement System Proteins / Q000032:analysis; D004912:Erythrocytes / Q000276:immunology; D006023:Glycoproteins / Q000032:analysis; D006801:Humans; D007122:Immunoelectrophoresis; D007962:Leukocytes / Q000276:immunology; D010949:Plasma / Q000276:immunology
D000706:Anaphylatoxins; D003174:Complement C1 Inactivator Proteins; D003176:Complement C3; D003181:Complement C4; D003182:Complement C5; D015937:Complement C5a, des-Arginine; D015938:Complement Membrane Attack Complex; D006023:Glycoproteins; C047610:SC5b-9 protein complex; D015926:Complement C3a; D015936:Complement C5a; D003165:Complement System Proteins