Critical Care Medicine

Adult Critical Care

Identification of lipids that accumulate during the routine storage of prestorage leukoreduced red blood cells and cause acute lung injury

Silliman CC, Moore EE, Kelher MR, et al (Denver Health Med, CO; Univ of Colorado Denver, Aurora) Transfusion 51:2549-2554, 2011^§

Abstract

Background

Lipids accumulate during the storage of red blood cells (RBCs), prime neutrophils (PMNs), and have been implicated in transfusion-related acute lung injury (TRALI). These lipids are composed of two classes: nonpolar lipids and lysophosphatidylcholines based on their retention time on separation by high-pressure liquid chromatography. Prestorage leukoreduction significantly decreases white blood cell and platelet contamination of RBCs; therefore, it is hypothesized that prestorage leukoreduction changes the classes of lipids that accumulate during storage, and these lipids prime PMNs and induce acute lung injury (ALI) as the second event in a two-event in vivo model.

Study Design and Methods

RBC units were divided: 50% was leukoreduced (LR-RBCs), stored, and sampled on Day 1 and at the end of storage, Day 42. Priming activity was evaluated on isolated PMNs, and the purified lipids from Day 1 or Day 42 were used as the second event in the in vivo model.

Results

The plasma and lipids from RBCs and LR-RBCs primed PMNs, and the LR-RBC activity decreased with longer storage. Unlike RBCs, nonpolar lipids comprised the PMN-priming activity from stored LR-RBCs. Mass spectroscopy identified these lipids as arachidonic acid and 5-, 12-, and 15-hydroxyeicosatetraenoic acid. At concentrations from Day 42, but not Day 1, three of four of these lipids individually, and the mixture, primed PMNs. The mixture also caused ALI as the second event in a two-event model of TRALI.

Only gold members can continue reading. Log In or Register to continue

Share this:

• Click to share on Twitter (Opens in new window)
• Click to share on Facebook (Opens in new window)

Related

Related posts:

of change in daily step count over five years with insulin sensitivity and adiposity: population based cohort study of Cancer: The Next Generation Beverages and Risk of Metabolic Syndrome and Type 2 Diabetes: A meta-analysis time and haemodynamic response after thiopental vs. propofol in the elderly: a randomized trial monitoring of neuromuscular block over the orbicularis oris muscle in anesthetized patients receiving vecuronium Is Better Than General Anesthesia During Endovascular Acute Stroke Interventions