Red cell transfusion in medicine: future challenges.
Many side-effects of red blood cell transfusion have been described. They include iron-overload, as well as allo- and autoantibody formation against red cells. During storage, erythrocytes undergo complex structural and biochemical changes. It has been suggested that accelerated and/or aberrant forms of the physiological erythrocyte aging process underlie the red cell storage lesion. This storage lesion may contribute to side-effects of transfusion as endothelial damage by release of internal erythrocyte constituents, (pro)inflammatory consequences, hampered microcirculation and oxygen delivery. Understanding the process that determines the fate of red blood cells after transfusion may contribute to the prevention of side-effects after red blood cell transfusion. This should be the focus of research on red blood cell transfusion in clinical transfusion medicine.
Novotny
V M J
VM
Department of Blood Transfusion and Transplantation Immunology (469), Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands. v.novotny@hemat.umcn.nl
D004905:Erythrocyte Aging; D017707:Erythrocyte Transfusion / Q000009:adverse effects; D004912:Erythrocytes / Q000276:immunology; D006801:Humans; D007108:Immune Tolerance / Q000502:physiology; D007249:Inflammation / Q000209:etiology; D019190:Iron Overload