Clinical application effects of leukocyte-filtered blood transfusions / 中国基层医药

Objective:To investigate the clinical application effects of leukocyte-filtered blood transfusions.Methods:A total of 120 patients with massive bleeding who received transfusions of a large amount of blood in the First People's Hospital of Yongkang, China from January 2017 to December 2018 were included in this study. They were divided into a control group (even numbers) and an observation group (odd numbers) according to registration numbers. The control group was subjected to direct blood transfusion. The observation group was given leukocyte-filtered blood transfusions. Coagulation function index, hemorheological index, cellular immune function, immunoglobulin level, body temperature, and the incidence of febrile non-hemolytic transfusion reactions were compared between the two groups.Results:After blood transfusions, prothrombin time, activated partial thromboplastin time, thrombin time in the observation group were (12.39 ± 1.41) seconds, (26.84 ± 6.47) seconds, and (14.32 ± 3.14) seconds, which were significantly shorter than those in the control group [(15.54 ± 2.03) seconds, (34.23 ± 7.59) seconds, (20.98 ± 4.27) seconds, t = 9.872, 5.740, 9.733, all P < 0.05]. Hematocrit, erythrocyte sedimentation rate, and plasma viscosity in the observation group were (39.28 ± 2.17)%, (25.97 ± 4.10) mm/h, and (2.19 ± 0.45) mp·s respectively, and those in the control group were (34.64 ± 4.52)%, (21.85 ± 3.64) mm/h, and (1.76 ± 0.42) mp·s respectively. There were significant differences in these indices between the two groups ( t = 9.87, 5.74, 9.73, all P < 0.05). There were significant differences in CD 3+, CD 4/CD 8, immunoglobulin G, immunoglobulin A, and immunoglobulin M between before and after blood transfusions in the control group ( t = 5.99, 5.91, 5.77, 5.80, 5.85, all P < 0.05). There were no significant differences in these indices between before and after blood transfusions in the observation group (all P > 0.05). After blood transfusions, body temperature was significantly lower in the observation group than in the control group [(36.58 ± 0.50) ℃ vs. (37.16±0.57)℃, t = 5.95, P < 0.05]. The incidence of febrile non-hemolytic transfusion reactions was significantly lower in the observation group than in the control group (1.67% vs. 13.33%, χ2 = 5.88, P < 0.05). Conclusion:Leukocyte-filtered blood transfusions can effectively restore the patient's body temperature to normal, improve coagulation function index and hemorheological index, reduce the impact of blood transfusions on the patient's immune function, and reduce febrile non-hemolytic transfusion reactions.

The Relationship between IL-1beta, TNFalpha, IL-6 and Factors Associated with Febrile Reactions to Transfused Blood

PURPOSE: Aggressive chemotherapy and bone marrow transplantation have a large demand for platelet concentrate and packed RBC transfusion. Febrile nonhemolytic transfusion reactions are an immunologically mediated reaction involving plasma in the recipient and the white blood cells in the donor. This study was performed to understand the role of cytokines and factors associated with febrile nonhemolytic transfusion reaction to transfused blood. METHODS: Samples were obtained from 42 transfused blood(36 packed RBC, 6 platelet concentrates). Initial WBC count, pH, LDH, irradiation, use of filter and storage time were checked. The serum levels of Interleukin-1beta(IL-1beta), Tumor necrosis factor alpha(TNFalpha) and Interleukin-6(IL-6) were measured by ELISA method using commercial kit for each cytokines. Transfusion reactions, including fever, were recorded in all cases. RESULTS: With the storage time of blood products longer in duration, the serum levels of IL-1beta, TNFalpha and IL-6 were significantly higher(P3000/mm3(P< 0.05). There was no relationship between cytokines and LDH, pH respectively. Febrile reaction was noted in 2.3%(1/42). CONCLUSION: Transfusion reactions are not always the result of an antigen-antibody reaction, but could be caused by the administration of large amounts of cytokines in the plasma. The longer storage times of blood products was associated with frequency of febrile transfusion reactions. We recommend fresh blood transfusion and reduction of WBC before storage because it abrogates cytokine accumulation and dramatically lowers the rate of febrile transfusion reaction.

The Relationship between IL-1beta, TNFalpha, IL-6 and Factors Associated with Febrile Reactions to Transfused Blood

PURPOSE: Aggressive chemotherapy and bone marrow transplantation have a large demand for platelet concentrate and packed RBC transfusion. Febrile nonhemolytic transfusion reactions are an immunologically mediated reaction involving plasma in the recipient and the white blood cells in the donor. This study was performed to understand the role of cytokines and factors associated with febrile nonhemolytic transfusion reaction to transfused blood. METHODS: Samples were obtained from 42 transfused blood(36 packed RBC, 6 platelet concentrates). Initial WBC count, pH, LDH, irradiation, use of filter and storage time were checked. The serum levels of Interleukin-1beta(IL-1beta), Tumor necrosis factor alpha(TNFalpha) and Interleukin-6(IL-6) were measured by ELISA method using commercial kit for each cytokines. Transfusion reactions, including fever, were recorded in all cases. RESULTS: With the storage time of blood products longer in duration, the serum levels of IL-1beta, TNFalpha and IL-6 were significantly higher(P3000/mm3(P< 0.05). There was no relationship between cytokines and LDH, pH respectively. Febrile reaction was noted in 2.3%(1/42). CONCLUSION: Transfusion reactions are not always the result of an antigen-antibody reaction, but could be caused by the administration of large amounts of cytokines in the plasma. The longer storage times of blood products was associated with frequency of febrile transfusion reactions. We recommend fresh blood transfusion and reduction of WBC before storage because it abrogates cytokine accumulation and dramatically lowers the rate of febrile transfusion reaction.