Transfusion of red blood cells after prolonged storage produces harmful effects that are mediated by iron and inflammation

摘要: Although red blood cell (RBC) transfusions can be lifesaving, they are not without risk. In critically ill patients, RBC associated with increased morbidity and mortality, which may increase prolonged storage before transfusion. The mechanisms responsible remain unknown. We hypothesized that acute clearance of a subset damaged, stored RBCs delivers large amounts iron to the monocyte/macrophage system, inducing inflammation. To test this in well-controlled setting, we used murine transfusion model show RBCs, or washed increases plasma nontransferrin bound (NTBI), produces tissue deposition, initiates contrast, fresh infusion RBC-derived supernatant, ghosts, stroma-free lysate, does produce these effects. Furthermore, insult induced by synergizes subclinical endotoxinemia producing clinically overt signs symptoms. NTBI also enhances bacterial growth vitro. Taken together, results suggest that, mouse model, cellular component leukoreduced, units contributes harmful effects occur after storage. Nonetheless, findings must confirmed prospective human studies.