Packed blood cells stored in AS-5 become proinflammatory during storage

Area of Science:

• Transfusion Medicine
• Immunology
• Hematology

Background:

• Packed red blood cells (PRBCs) stored in certain solutions accumulate inflammatory substances.
• This accumulation may increase transfusion complications.
• The study investigates PRBCs stored in AS-5 solution.

Purpose of the Study:

• To determine if AS-5 supernates from PRBCs activate neutrophils and platelets.
• To assess the accumulation of inflammatory cytokines and granule constituents in AS-5 PRBC supernates.
• To evaluate the impact of leukoreduction on these inflammatory changes.

Main Methods:

• PRBC units (non-leukoreduced and leukoreduced) were stored in AS-5.
• Supernates were analyzed for cytokines and myeloperoxidase (MPO) using multiplex ELISA.
• Supernates were incubated with blood to assess neutrophil and platelet activation via flow cytometry.

Main Results:

• Supernates from non-leukoreduced (NLR) PRBCs stored for ≥14 days increased neutrophil activation and platelet-PMN aggregates.
• These effects intensified with storage duration.
• Leukoreduced (LR) PRBC supernates did not induce these inflammatory responses.
• Elevated levels of IL-1β, IL-6, IL-8, IL-18, NAP-2, MCP-1, RANTES, and MPO were found in aged NLR PRBC supernates.

Conclusions:

• Non-leukoreduced PRBCs stored in AS-5 become progressively more proinflammatory over time.
• Leukoreduction effectively mitigates the development of inflammatory properties in stored PRBCs.
• Leukoreduction is crucial for maintaining the safety of stored PRBCs.