Bradykinin-associated reactions in white cell-reduction filter

Purpose: The purpose of this study was to examine the effect of temperature on bradykinin generation during blood transfusion using positively charged (positive filter), negatively charged (negative filter), and neutral (neut ral filter) filters. Materials and Methods: Whole blood collected from six volunteers at 4 degre esC or 37 degreesC was passed through the positive or negative filter. In s ix surgical patients during surgery, autologous blood transfusion at 37 deg reesC was initiated through the positive filter, and the same transfusion w as reintroduced through the negative filter. Whole blood from another six v olunteers at 4 degrees or 37 degreesC was passed through the neutral filter . Results: The positive filter did not generate bradykinin at any temperature , whereas the negative filter generated bradykinin by approximately 4,000-f old when warm blood was used but did not at cool blood. Blood pressure decr eased and heart rate increased during warm blood transfusion using the nega tive filter but did not change using the positive filter. Plasma bradykinin levels increased in patients with use of the negative filter. The neutral filter generated bradykinin when warm blood was used but at levels lower th an for the negative filter. Conclusions: Use of negative filter results in the temperature-dependent ge neration of bradykinin, which becomes a potential anaphylatoxin when warm b lood is used. Copyright (C) 2001 by W.B. Saunders Company.