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


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 degrees C. Hematologic status and hemolysis were studied. The lipopolysaccharide (LPS)-induced production of tumor necrosis factor (TNF)-alpha and transforming growth factor (TGF)-beta1 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-alpha and TGF-beta1 decreased and increased, respectively. There were no significant changes in the LPS-induced production of TNF-alpha and TGF-beta1 in the leukoreduced CB RBC units.


CONCLUSIONS
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-alpha and TGF-beta1 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.
Widing
Line
L
Departments of Pediatrics and Immunology & Transfusion Medicine, Ullevål University Hospital, University of Oslo, Kirkeveien 166, N-0407 Oslo, Norway.
Bechensteen
Anne Grete
AG
Mirlashari
Mohammad Reza
MR
Vetlesen
Annette
A
Kjeldsen-Kragh
Jens
J
D001804:Blood Transfusion, Autologous; D017707:Erythrocyte Transfusion; D005260:Female; D005312:Fetal Blood / Q000166:cytology*; D006801:Humans; D047589:Leukocyte Reduction Procedures; D008070:Lipopolysaccharides / Q000494:pharmacology; D011247:Pregnancy; D053773:Transforming Growth Factor beta1 / Q000096:biosynthesis; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis
D008070:Lipopolysaccharides; D053773:Transforming Growth Factor beta1; D014409:Tumor Necrosis Factor-alpha