Transfusion
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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. ⋯ We conclude that the nonpolar lipids that accumulate during LR-RBC storage may represent the agents responsible for antibody-negative TRALI.
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Obstetric services depend on the transfusion service (TS) to provide diagnostic testing and blood component therapy for clinical care pathways. ⋯ QI initiatives for RhIG prophylaxis, diagnostic blood test ordering, and MTP improve TS support of obstetric services.
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Although a subset of recent studies have suggested that red blood cell (RBC) storage length is associated with adverse patient outcomes, others have shown no such relationship. Adults may be transfused with RBC units of different storage lengths, and existing studies do not take into consideration that fresh RBCs may alter responses to concurrently transfused stored RBCs. To test this possibility, we utilized a murine model and investigated transfusion outcomes of fresh, stored, or fresh-plus-stored RBCs. ⋯ These results are consistent with fresh murine HOD RBCs losing protective properties during storage, and introduce a previously unrecognized variable in RBC storage studies. If translatable to humans, uniform "old blood" groups may be needed in future clinical studies to more accurately investigate the biologic effects of older RBC units.
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Multicenter Study Clinical Trial
Hemoglobin and iron indices in nonanemic premenopausal blood donors predict future deferral from whole blood donation.
Iron deficiency anemia is an important reason for blood donor deferral. We prospectively determined whether screening donors with hemoglobin (Hb) and iron indices before donation can predict subsequent deferral due to anemia. ⋯ Screening with Hb and iron indices enables prediction of donors at risk of subsequent anemia and who would most benefit from prevention strategies.
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Mesenchymal stromal cells (MSCs) originally isolated from marrow have multipotent differentiation potential and favorable immunomodulatory and anti-inflammatory properties that make them very attractive for regenerative cellular therapy. Cells with similar phenotypic characteristics have now been derived from almost all fetal, neonatal, and adult tissues; furthermore, more recently similar cells have also been generated from human embryonic stem cells (ESCs). Generation of MSCs from human ESCs provides an opportunity to study the developmental biology of human mesenchymal lineage generation in vitro. ⋯ MSCs from adult sources are being investigated in numerous Phase I-III clinical trials for a wide variety of indications, mainly based on their immunomodulatory properties. Our group and others have shown MSCs derived from human ESCs possess immunomodulatory properties similar to marrow-derived MSCs. Immunomodulatory properties of ESC-derived MSCs could prove to be highly valuable for their potential clinical applications in the future as derivatives of human ESCs have already entered clinical arena in the context of Phase I clinical trials.