ABSTRACT
BACKGROUND: Several recent studies have reported that generation of inflammatory cytokines and activation of complements may be associated with febrile nonhemolytic transfusion reactions (FNHTR). However, few data are available for whole blood, which is still commonly utilized for massive transfusion and for autologous transfusion. METHODS: A total of 15 whole blood units from healthy adult donors was collected and stored at 4degrees C for 35 days. During the storage time, samples for analyses of cytokines including interleukin-1alpha (IL-1alpha), IL-2, IL-6, IL-8, and tumor necrosis factor alpha (TNFalpha) and anaphylatoxins such as C3a and C5a were obtained on day 0, 1, 3, 5, 7, 14, 28, and 35. Cytokines were measured by enzyme-linked immunosorbent assay and anaphylatoxins by radioimmunoassay. RESULTS: IL-1alpha (<0.5 pg/mL), IL-2 (<7 pg/mL), and TNFalpha (<4.4 pg/mL) were not detectable. IL-6 was measured in 4 units with low level (1.1-4.0 pg/mL) and IL-8 showed slightly higher level (10.5 pg/mL) on day 35. Anaphylatoxins (C3a and C5a) were detectable at the level of 1350.0 ng/mL on day 21 and of 14.6 ng/mL on day 14, respectively, which were significantly increased levels compared with those on day 0. The levels of C3a and C5a reached 2513.3 ng/mL and 18.4 ng/mL on day 35, respectively. CONCLUSIONS: It is not likely that cytokines generated during storage of whole blood under normal blood banking condition could explain FNHTR. However, anaphylatoxins are elevated in whole blood after 2 weeks of storage, which might be due to complement activation by the plastic surface of blood bag.