title: Large animal evaluation of riboflavin and ultraviolet light-treated whole blood transfusion in a diffuse, nonsurgical bleeding porcine model.
abstract: BACKGROUND
  The Mirasol system has been demonstrated to effectively inactivate white blood cells (WBCs) and reduce pathogens in whole blood in vitro. The purpose of this study was to compare the safety and efficacy of Mirasol-treated fresh whole blood (FWB) to untreated FWB in an in vivo model of surgical bleeding.
  
  
  METHODS
  A total of 18 anesthetized pigs (40 kg) underwent a 35% total blood volume bleed, cooling to 33°C, and a standardized liver injury. Animals were then randomly assigned to resuscitation with either Mirasol-treated or untreated FWB, and intraoperative blood loss was measured. After abdominal closure, the animals were observed for 14 days, after which the animals were euthanized and tissues were obtained for histopathologic examination. Mortality, tissue near-infrared spectroscopy, red blood cell (RBC) variables, platelets (PLTs), WBCs, and coagulation indices were analyzed.
  
  
  RESULTS
  Total intraoperative blood loss was similar in test and control arms (8.3 ± 3.2 mL/kg vs. 7.7 ± 3.9 mL/kg, p = 0.720). All animals survived to Day 14. Trended values over time did not show significant differences-tissue oxygenation (p = 0.605), hemoglobin (p = 0.461), PLTs (p = 0.807), WBCs (p = 0.435), prothrombin time (p = 0.655), activated partial thromboplastin time (p = 0.416), thromboelastography (TEG)-reaction time (p = 0.265), or TEG-clot formation time (p = 0.081). Histopathology did not show significant differences between arms.
  
  
  CONCLUSIONS
  Mirasol-treated FWB did not impact survival, blood loss, tissue oxygen delivery, RBC indices, or coagulation variables in a standardized liver injury model. These data suggest that Mirasol-treated FWB is both safe and efficacious in vivo.
authors.affiliation: Division of Trauma Surgery and Surgical Critical Care, Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California.
authors.forename: Obi T
authors.initials: OT
authors.lastname: Okoye
authors.forename: Heather
authors.initials: H
authors.lastname: Reddy
authors.forename: Monica D
authors.initials: MD
authors.lastname: Wong
authors.forename: Suzann
authors.initials: S
authors.lastname: Doane
authors.forename: Shelby
authors.initials: S
authors.lastname: Resnick
authors.forename: Efstathios
authors.initials: E
authors.lastname: Karamanos
authors.forename: Dimitra
authors.initials: D
authors.lastname: Skiada
authors.forename: Raymond
authors.initials: R
authors.lastname: Goodrich
authors.forename: Kenji
authors.initials: K
authors.lastname: Inaba
mesh_terms: D000818:Animals; D001769:Blood / Q000187:drug effects* / Q000528:radiation effects*; D001773:Blood Cells / Q000187:drug effects / Q000528:radiation effects; D001780:Blood Coagulation Tests; D001793:Blood Preservation; D058731:Blood Safety; D001803:Blood Transfusion / Q000379:methods*; D004909:Erythrocyte Indices; D005260:Female; D006438:Hemodilution; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy*; D007036:Hypothermia, Induced; D022125:Lacerations / Q000150:complications / Q000628:therapy; D007813:Laparotomy; D008099:Liver / Q000293:injuries / Q000473:pathology; D008297:Male; D011897:Random Allocation; D012151:Resuscitation / Q000379:methods*; D012256:Riboflavin / Q000494:pharmacology*; D034421:Sus scrofa; D013552:Swine; D013916:Thrombelastography; D014466:Ultraviolet Rays
chemical_list: D012256:Riboflavin