TIME-DEPENDENT, SPONTANEOUS RELEASE OF WHITE CELL-DERIVED AND PLATELET-DERIVED BIOACTIVE SUBSTANCES FROM STORED HUMAN BLOOD

Background: The mechanisms of the detrimental effects of perioperative allogeneic blood transfusion are still unclear. Previous studies have suggested a higher incidence oi adverse effects after the use of bloo d stored for prolonged time. therefore, a possible time-dependent rele ase of various white cell- and platelet-derived bioactive substances i n stored human red cell suspensions was studied. Study Design and Meth ods: Whole blood (6 units), plasma-reduced whole blood (6 units), and saline-adenine-glucose-mannitol blood (6 units) from 18 unpaid, normal blood donors were stared under standard blood bank conditions at 4 de grees C for 35 days. After refrigeration, samples were collected from all blood bags on Days 0, 2, 5, 9, 14, 21, 28, and 35 of storage. Extr acellular concentrations of eosinophil cationic protein, eosinophil pr otein X, plasminogen activator inhibitor 1, myeloperoxidase, and inter leukin 6 were analyzed by enzyme-linked immunosorbent assay and radioi mmunoassay. The total intracellular and donor plasma levels of these s ubstances also were analyzed at the time of blood donation. Results: E osinophil cationic protein, eosinophil protein X, and myeloperoxidase increased 10- to 25-fold (p<0.05) in a time-dependent manner in whole blood, plasma-reduced whole blood, and saline adenine-glucose-mannitol blood during storage for 35 days. Plasminogen activator inhibitor 1 i ncreased threefold to sixfold (p<0.05) in whole blood and plasma-reduc ed whole blood, but not in saline-adenine-glucose-mannitol blood. inte rleukin 6 was not detected in either plasma or samples obtained from t he blood bags. Conclusion: Stored whole blood, plasma-reduced whole bl ood, and saline-adenine-glucose-mannitol blood may release white cell- and platelet-derived bioactive substances in a time-dependent manner, which may be related to the detrimental effects of perioperative bloo d transfusions. Therefore, prestorage white cell reduction should be c onsidered for further improvement of red cell suspensions.