Transfusion-associated adverse reactions (TAARs) and cytokine accumulations in the stored blood components: the impact of prestorage versus poststorage leukoreduction
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Chih-Chun Chang1,*, Tai-Chen Lee1,*, Ming-Jang Su1, Hsiu-Chen Lin1, Fang-Yi Cheng1, Yi-Ting Chen1, Tzung-Hai Yen2,3 and Fang-Yeh Chu1,4,5,6
1Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan
2Department of Nephrology and Division of Clinical Toxicology and Toxicology Laboratory, Chang Gung Memorial Hospital, Lin-Kou Medical Center, Taoyuan, Taiwan
3College of Medicine, Chang Gung University, Taoyuan, Taiwan
4School of Medical Laboratory Science and Biotechnology, Taipei Medical University, Taipei, Taiwan
5Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan
6Department of Medical Laboratory Science and Biotechnology, Yuanpei University, Hsinchu, Taiwan
*These authors contributed equally to this work
Fang-Yeh Chu, email: [email protected]
Keywords: cytokines; prestorage leukoreduction; poststorage leukoreduction; febrile nonhemolytic transfusion reactions; transfusion-associated adverse reactions
Received: July 12, 2017 Accepted: November 13, 2017 Published: December 07, 2017
Leukoreduction in blood units could prevent patients undergoing transfusions from transfusion-associated adverse reactions (TAARs) such as febrile nonhemolytic transfusion reactions (FNHTRs). However, the effect of prestorage and poststorage leukoreduction on TAARs and its underlying mechanisms in stored blood components remains to be determined. Therefore, we investigated the impact of prestorage leukocyte-reduced (pre-LR) and poststorage leukocyte-reduced (post-LR) blood products, including red blood cells (RBCs) and apheresis platelets (PHs), on the incidence of FNHTRs and other TAARs in patients who received transfusions from 2009 to 2014 in a tertiary care center. We also investigated the difference of leukocyte-related bioactive mediators between pre- and post-LR blood components. The results indicated that prevalence of TAARs was significantly reduced in the transfusions of pre-LR blood components. Particularly, the prevalence of FNHTRs was significantly reduced in the pre-LR RBC transfusions and the prevalence of allergy reactions was markedly reduced in the pre-LR PH transfusions. Furthermore, in vitro evaluation of cytokines in the pre- and post-LR blood components revealed that IL-1β, IL-8 and RANTES levels were significantly elevated in the post-LR RBCs during the storage. In contrast, IL-1β, IL-6 and IL-8 levels were significantly elevated in the post-LR PHs during the storage. These findings suggested that prestorage leukoreduction had a diminishing effect on the development of TAARs, which could be associated with less accumulation of cytokines in the stored blood components.
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