Transfusion medicine

Question 1

What are “storage lesions”? Stefani et al, 2020, JVIM

Answer 1

morphological and biochemical changes occur in stored blood, reducing the function and the survival of RBCs and potentially causing adverse effects in recipients.

Question 2

What are the metabolits of leukocytes, implicated to cause storage lesions and cause transfusion reactions? Stefani et al, 2020, JVIM

Answer 2

In particular, the metabolites of leukocytes such as cytokines, histamine, elastase, and acid phosphatase seem fundamental to the development of storage lesions and post-transfusion reactions.

Question 3

How does leukoreduction affect platelet counts in stored blood products? Stefani et al, 2020, JVIM

Answer 3

an almost complete platelet depletion was observed after leukoreduciton

Question 4

How is leukoreduction performed? Stefani et al, 2020, JVIM

Answer 4

prestorage leukoreduction via specialized filter causing decrease of leukocyte to less than 1-5 x 10⁶ per unit of blood product

Question 5

What are typical changes occuring in blood products over time? Stefani et al, 2020, JVIM

Question 6

Conclusion: Effects of leukoreduction on storage lesions in whole blood and blood components of dogs (Stefani et al, 2020, JVIM)

Answer 6

LR blood units are recommended to critically ill dogs with marked inflammatory conditions.

Question 7

What effects did leukoreduction have on blood products in Stefani et al, 2020, JVIM

Answer 7

• almost complete platelet depletion
• less decrease in pH over time

less increase in lactate concentration over time

• less increase in K concentration over time
• less factor VIII, fibrinogen and elevated aPTT
• lower interleukin-8 concentration
• no significant effect on hemolysis

Question 8

Name the biomechanical RBC storage lesions.

Obrador et al, 2015, JVECC

Answer 8

• RBC shape change
• reduced RBC deformability
• microparticle accumulation
• adhesion to endothelial cells

Question 9

Conclusion : Effect of Leukoreduction on Transfusion-Induced Inflammation in Dogs (McMichael at al, 2010, JVIM)

Answer 9

There is a profound inflammatory response to transfusion in normal dogs, which is eliminated by LR of the pRBC units.

Question 10

What are the 3 main categories of RBC storage lesions according to Kisielewicz et al, 2014 Vet Anesthesia and Analgesia

Answer 10

• morphologic changes
• metabolic derangements
• oxidative injuries

Question 11

What are the 3 main categories of RBC storage lesions according to Obrador, 2015, JVECC?

Answer 11

• biochemical changes
• biomechanical changes
• immunologic changes

Question 12

List the biochemical RBC storage lesions.

Obrador, 2015, JVECC

Answer 12

• decreased adenosine triphosphate
• decreased 2,3-diphosphoglycerate
• nitric oxide axccumulation
• inreased potassium
• ammonia accumulation
• oxidation injury

Question 13

name the immunologic changes of the RBC storage lesions

Obrador et al, 2015, JVECC

Answer 13

• leukocyte contamination
• soluble immune response modifiers