Tags

Type your tag names separated by a space and hit enter

Effects of red blood cell (RBC) transfusion on sickle cell disease recipient plasma and RBC metabolism.
Transfusion. 2018 12; 58(12):2797-2806.T

Abstract

BACKGROUND

Exchange transfusion is a mainstay in the treatment of sickle cell anemia. Transfusion recipients with sickle cell disease (SCD) can be transfused over 10 units per therapy, an intervention that replaces circulating sickle red blood cells (RBCs) with donor RBCs. Storage of RBCs makes the intervention logistically feasible. The average storage duration for units transfused at the Duke University Medical Center is approximately 2 weeks, a time window that should anticipate the accumulation of irreversible storage lesion to the RBCs. However, no metabolomics study has been performed to date to investigate the impact of exchange transfusion on recipients' plasma and RBC phenotypes.

STUDY DESIGN AND METHODS

Plasma and RBCs were collected from patients with sickle cell anemia before transfusion and within 5 hours after exchange transfusion with up to 11 units, prior to metabolomics analyses.

RESULTS

Exchange transfusion significantly decreased plasma levels of markers of systemic hypoxemia like lactate, succinate, sphingosine 1-phosphate, and 2-hydroxyglutarate. These metabolites accumulated in transfused RBCs, suggesting that RBCs may act as scavenger/reservoirs. Transfused RBCs displayed higher glycolysis, total adenylate pools, and 2,3-diphosphoglycerate, consistent with increased capacity to deliver oxygen. Plasma levels of acyl-carnitines and amino acids decreased, while fatty acids and potentially harmful phthalates increased upon exchange transfusion.

CONCLUSION

Metabolic phenotypes confirm the benefits of the transfusion therapy in transfusion recipients with SCD and the reversibility of some of the metabolic storage lesion upon transfusion in vivo in 2-week-old RBCs. However, results also suggest that potentially harmful plasticizers are transfused.

Authors+Show Affiliations

Department of Biochemistry and Molecular Genetics, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado.Duke University Medical Center, Durham, North Carolina.Department of Biochemistry and Molecular Genetics, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado.Duke University Medical Center, Durham, North Carolina.Duke University Medical Center, Durham, North Carolina.Duke University Medical Center, Durham, North Carolina.Duke University Medical Center, Durham, North Carolina.Department of Biochemistry and Molecular Genetics, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado.

Pub Type(s)

Clinical Trial
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30265764

Citation

Culp-Hill, Rachel, et al. "Effects of Red Blood Cell (RBC) Transfusion On Sickle Cell Disease Recipient Plasma and RBC Metabolism." Transfusion, vol. 58, no. 12, 2018, pp. 2797-2806.
Culp-Hill R, Srinivasan AJ, Gehrke S, et al. Effects of red blood cell (RBC) transfusion on sickle cell disease recipient plasma and RBC metabolism. Transfusion. 2018;58(12):2797-2806.
Culp-Hill, R., Srinivasan, A. J., Gehrke, S., Kamyszek, R., Ansari, A., Shah, N., Welsby, I., & D'Alessandro, A. (2018). Effects of red blood cell (RBC) transfusion on sickle cell disease recipient plasma and RBC metabolism. Transfusion, 58(12), 2797-2806. https://doi.org/10.1111/trf.14931
Culp-Hill R, et al. Effects of Red Blood Cell (RBC) Transfusion On Sickle Cell Disease Recipient Plasma and RBC Metabolism. Transfusion. 2018;58(12):2797-2806. PubMed PMID: 30265764.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of red blood cell (RBC) transfusion on sickle cell disease recipient plasma and RBC metabolism. AU - Culp-Hill,Rachel, AU - Srinivasan,Amudan J, AU - Gehrke,Sarah, AU - Kamyszek,Reed, AU - Ansari,Andrea, AU - Shah,Nirmish, AU - Welsby,Ian, AU - D'Alessandro,Angelo, Y1 - 2018/09/28/ PY - 2018/06/28/received PY - 2018/08/01/revised PY - 2018/08/01/accepted PY - 2018/9/29/pubmed PY - 2019/4/10/medline PY - 2018/9/29/entrez SP - 2797 EP - 2806 JF - Transfusion JO - Transfusion VL - 58 IS - 12 N2 - BACKGROUND: Exchange transfusion is a mainstay in the treatment of sickle cell anemia. Transfusion recipients with sickle cell disease (SCD) can be transfused over 10 units per therapy, an intervention that replaces circulating sickle red blood cells (RBCs) with donor RBCs. Storage of RBCs makes the intervention logistically feasible. The average storage duration for units transfused at the Duke University Medical Center is approximately 2 weeks, a time window that should anticipate the accumulation of irreversible storage lesion to the RBCs. However, no metabolomics study has been performed to date to investigate the impact of exchange transfusion on recipients' plasma and RBC phenotypes. STUDY DESIGN AND METHODS: Plasma and RBCs were collected from patients with sickle cell anemia before transfusion and within 5 hours after exchange transfusion with up to 11 units, prior to metabolomics analyses. RESULTS: Exchange transfusion significantly decreased plasma levels of markers of systemic hypoxemia like lactate, succinate, sphingosine 1-phosphate, and 2-hydroxyglutarate. These metabolites accumulated in transfused RBCs, suggesting that RBCs may act as scavenger/reservoirs. Transfused RBCs displayed higher glycolysis, total adenylate pools, and 2,3-diphosphoglycerate, consistent with increased capacity to deliver oxygen. Plasma levels of acyl-carnitines and amino acids decreased, while fatty acids and potentially harmful phthalates increased upon exchange transfusion. CONCLUSION: Metabolic phenotypes confirm the benefits of the transfusion therapy in transfusion recipients with SCD and the reversibility of some of the metabolic storage lesion upon transfusion in vivo in 2-week-old RBCs. However, results also suggest that potentially harmful plasticizers are transfused. SN - 1537-2995 UR - https://www.unboundmedicine.com/medline/citation/30265764/Effects_of_red_blood_cell__RBC__transfusion_on_sickle_cell_disease_recipient_plasma_and_RBC_metabolism_ L2 - https://doi.org/10.1111/trf.14931 DB - PRIME DP - Unbound Medicine ER -