Analysis of leucocyte antibodies, cytokines, lysophospholipids and cell microparticles in blood components implicated in post-transfusion reactions with dyspnoea.

BACKGROUND AND OBJECTIVES: Post-transfusion reactions with dyspnoea (PTR) are major causes of morbidity and death after blood transfusion. Transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) are most dangerous, while transfusion-associated dyspnoea (TAD) is a milder respiratory distress. We investigated blood components for immune and non-immune factors implicated in PTR. MATERIAL AND METHODS: We analysed 464 blood components (RBCs, PLTs, L-PLTs, FFP) transfused to 271 patients with PTR. Blood components were evaluated for 1/antileucocyte antibodies, 2/cytokines: IL-1ß, IL-6, IL-8, TNF-α, sCD40L, 3/lysophosphatidylcholines (LysoPCs), 4/microparticles (MPs) shed from plateletes (PMPs), erythrocytes (EMPs) and leucocytes (LMPs). RESULTS: Anti-HLA class I/II antibodies or granulocyte-reactive anti-HLA antibodies were detected in 18.2% of blood components (RBC and FFP) transfused to TRALI and in 0.5% of FFP transfused to TAD cases. Cytokines and LysoPCs concentrations in blood components transfused to PTR patients did not exceed those in blood components transfused to patients with no PTR. Only EMPs percentage in RBCs transfused to patients with TRALI was significantly higher (P < 0.05) than in RBCs transfused to patients with no PTR. CONCLUSION: Immune character of PTR was confirmed mainly in 1/5 TRALI cases. Among non-immune factors, only MPs released from stored RBCs are suggested as potential mediators of TRALI. Our results require further observations in a more numerous and better defined group of patients.

[Comparison of platelet concentrates obtained using blood cell separators with continuous flow: CS-3000 and Cobe-Spectra]. / Porównanie jakosci koncentratów plytkowych otrzymanych przy uzyciu separatorów z przeplywem ciaglym: CS-3000 i Cobe-Spectra.

During a platelet apheresis procedure on CS-3000 the platelet concentrate (Pc) is centrifugated for about 1.5 h. In the Cobe system Pc is gradually collected in a container located outside the machine. Influence of both techniques on platelet viability and function was examined in vitro. MPV, hypotonic stress response (HSR), aggregation using ADP, activity and percent leakage of lactic dehydrogenase (LDH) were similar in both groups. ATP contents in platelets (Plts) obtained on CS-3000 reached 5.18 +/- 0.75 mumol/10(11) Plts and was significantly lower than in Plts collected on Cobe-Spectra: 7.26 +/- 1.00 mumol/10(11) Plts. The functions of Plts obtained on both blood cell separators, immediately after collection, appeared to be correct. ATP level reduction in Plts from CS-3000 suggests that prolonged centrifugation leads to Plts activation which can affect cells during storage.

[Comparison of platelet and leukocyte content in platelet concentrates obtained from CS-3000 and third generation (CS-3000 plus and Cobe-Spectra) cell separators]. / Porównanie zawartosci plytek krwi i leukocytów w koncentratach krwinek plytkowych, otrzymanych przy uzyciu separatora CS-3000 oraz separatorów III generacji (CS-3000 plus i Cobe-Spectra).

Platelet concentrates (PCs) obtained using old generation of cell separators contain high number of leukocytes. White cell (WBC) contamination and platelet (Plts) number in PCs obtained from separator II-nd generation CS-3000 and separators III-rd generations CS-3000 plus and Cobe-Spectra have been determined. PCs from new separators contain the same Plts number as PCs from CS-3000. The average leukocyte count in PCs obtained from CS-3000 was 171.26 x 10(6), whereas WBC number in PCs from CS-3000 plus and Cobe-Spectra were 2.87 and 2.54 x 10(6) respectively. In about 85% of PCs obtained from III-rd generation cell separators the leukocyte count did not exceed 5 x 10(6). This count is considered sufficient to prevent alloimmunization of HLA antigens. The determination of WBC count in every PCs allows to select PCs with fewer than 5 x 10(6) leukocytes and to transfuse them without the necessity of using expensive filters for leukocyte removing.