title: Non-polar lipids accumulate during storage of transfusion products and do not contribute to the onset of transfusion-related acute lung injury.
abstract: OBJECTIVE
  The accumulation of non-polar lipids arachidonic acid, 5-hydroxyeicosatetraenoic acid (HETE), 12-HETE and 15-HETE during storage of transfusion products may play a role in the onset of transfusion-related acute lung injury (TRALI), a syndrome of respiratory distress after transfusion.
  
  
  METHODS
  We investigated non-polar lipid accumulation in red blood cells (RBCs) stored for 42 days, plasma stored for 7 days at either 4 or 20°C and platelet (PLT) transfusion products stored for 7 days. Furthermore, we investigated whether transfusion of RBCs with increased levels of non-polar lipids induces TRALI in a 'two-hit' human volunteer model. All products were produced following Dutch Blood Bank protocols and are according to European standards. Non-polar lipids were measured with high-performance liquid chromotography followed by mass spectrometry.
  
  
  RESULTS
  All non-polar lipids increased in RBCs after 21 days of storage compared to baseline. The non-polar lipid concentration in plasma increased significantly, and the increase was even more pronounced in products stored at 20°C. In platelets, baseline levels of 5-HETE and 15-HETE were higher than in RBCs or plasma. However, the non-polar lipids did not change significantly during storage of PLT products. Infusion of RBCs with increased levels of non-polar lipids did not induce TRALI in LPS-primed human volunteers.
  
  
  CONCLUSIONS
  We conclude that non-polar lipids accumulate in RBC and plasma transfusion products and that accumulation is temperature dependent. Accumulation of non-polar lipids does not appear to explain the onset of TRALI (Dutch Trial Register - NTR4455).
authors.affiliation: Laboratory of Experimental Intensive Care and Anesthesia, Academic Medical Center, Amsterdam, The Netherlands.|Department of Intensive Care, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: A L
authors.initials: AL
authors.lastname: Peters
authors.affiliation: Laboratory Genetic Metabolic Diseases, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: M A T
authors.initials: MA
authors.lastname: Vervaart
authors.affiliation: Department of Blood Cell Research, Sanquin Research, Amsterdam, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: van Bruggen
authors.affiliation: Department of Blood Cell Research, Sanquin Research, Amsterdam, The Netherlands.|Department Product and Process Development, Sanquin Blood Bank, Amsterdam, The Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: de Korte
authors.affiliation: Laboratory for Experimental Clinical Chemistry, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Nieuwland
authors.affiliation: Laboratory Genetic Metabolic Diseases, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: W
authors.initials: W
authors.lastname: Kulik
authors.affiliation: Laboratory of Experimental Intensive Care and Anesthesia, Academic Medical Center, Amsterdam, The Netherlands.|Department of Intensive Care, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: A P J
authors.initials: AP
authors.lastname: Vlaar
mesh_terms: D019377:12-Hydroxy-5,8,10,14-eicosatetraenoic Acid / Q000097:blood; D055371:Acute Lung Injury / Q000209:etiology*; D000293:Adolescent; D000328:Adult; D016718:Arachidonic Acid / Q000097:blood; D001792:Blood Platelets / Q000166:cytology / Q000378:metabolism; D001793:Blood Preservation; D001804:Blood Transfusion, Autologous; D002851:Chromatography, High Pressure Liquid; D004912:Erythrocytes / Q000166:cytology / Q000378:metabolism; D006801:Humans; D006893:Hydroxyeicosatetraenoic Acids / Q000097:blood; D008055:Lipids / Q000097:blood*; D008070:Lipopolysaccharides / Q000633:toxicity; D008297:Male; D008962:Models, Theoretical; D017713:Platelet Transfusion / Q000009:adverse effects; D012042:Registries; D053719:Tandem Mass Spectrometry; D013696:Temperature; D013997:Time Factors; D065227:Transfusion Reaction; D055815:Young Adult
chemical_list: D006893:Hydroxyeicosatetraenoic Acids; D008055:Lipids; D008070:Lipopolysaccharides; D016718:Arachidonic Acid; C022022:5-hydroxy-6,8,11,14-eicosatetraenoic acid; D019377:12-Hydroxy-5,8,10,14-eicosatetraenoic Acid; C025984:15-hydroxy-5,8,11,13-eicosatetraenoic acid
keywords: arachidonic acid; human model; hydroxyeicosatetraenoic acid; non-polar lipids; storage; transfusion products