Berra, Lorenzo, Coppadoro, Andrea, Yu, Binglan, Lei, Chong, Spagnolli, Ester, Steinbicker, Andrea U., Bloch, Kenneth D., Lin, Tian, Sammy, Fatima Y., Warren, H. Shaw, Fernandez, Bernadette O., Feelisch, Martin, Dzik, Walter H., Stowell, Christopher P. and Zapol, Warren M. (2012) Transfusion of stored autologous blood does not alter reactive hyperemia index in healthy volunteers. Anesthesiology, Volume 117 (Number 1). pp. 56-63. doi:10.1097/ALN.0b013e31825575e6 ISSN 0003-3022.

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Abstract

Background: Transfusion of human blood stored for more than 2 weeks is associated with increased mortality and morbidity. During storage, packed erythrocytes progressively release hemoglobin, which avidly binds nitric oxide. We hypothesized that the nitric oxide mediated hyperemic response after ischemia would be reduced after transfusion of packed erythrocytes stored for 40 days. Methods and Results: We conducted a crossover randomized interventional study, enrolling 10 healthy adults. Nine volunteers completed the study. Each volunteer received one unit of 40-day and one of 3-day stored autologous leukoreduced packed erythrocytes, on different study days according to a randomization scheme. Blood withdrawal and reactive hyperemia index measurements were performed before and 10 min, 1 h, 2 h, and 4 h after transfusion. The reactive hyperemia index during the first 4 h after transfusion of 40-day compared with 3-day stored packed erythrocytes was unchanged. Plasma hemoglobin and bilirubin concentrations were higher after transfusion of 40-day than after 3-day stored packed erythrocytes (P = 0.02, [95% CI difference 10-114 mg/l] and 0.001, [95% CI difference 0.6-1.5 mg/dl], respectively). Plasma concentrations of potassium, lactate dehydrogenase, haptoglobin, and cytokines, as well as blood pressure, did not differ between the two transfusions and remained within the normal range. Plasma nitrite concentrations increased after transfusion of 40-day stored packed erythrocytes, but not after transfusion of 3-day stored packed erythrocytes (P = 0.01, [95% CI difference 0.446-0.66 μM]). Conclusions: Transfusion of autologous packed erythrocytes stored for 40 days is associated with increased hemolysis, an unchanged reactive hyperemia index, and increased concentrations of plasma nitrite. © 2012 the American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins.

Item Type:	Journal Article
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title:	Anesthesiology
Publisher:	Lippincott Williams & Wilkins
ISSN:	0003-3022
Official Date:	July 2012
Dates:	Date Event July 2012 Published
Volume:	Volume 117
Number:	Number 1
Page Range:	pp. 56-63
DOI:	10.1097/ALN.0b013e31825575e6
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access

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