Frequent blood donations alter susceptibility of red blood cells to storage- and stress-induced hemolysis
Corresponding Author
Tamir Kanias
Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
Address reprint requests to: Tamir Kanias, Vitalant Research Institute, 717 Yosemite Street, Denver, CO 80230; e-mail: [email protected]Search for more papers by this authorMars Stone
Blood Systems Research Institute, San Francisco, and Department of Laboratory Medicine, University of California, San Francisco, California
Search for more papers by this authorYuelong Guo
RTI International, Research Triangle Park, North Carolina
Search for more papers by this authorMarion C. Lanteri
Blood Systems Research Institute, San Francisco, and Department of Laboratory Medicine, University of California, San Francisco, California
Search for more papers by this authorBryan R. Spencer
American Red Cross Blood Services, Dedham, Massachusetts
Search for more papers by this authorDarrell J. Triulzi
Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania
The Institute for Transfusion Medicine, Pittsburgh, Pennsylvania
Search for more papers by this authorJoseph E. Kiss
The Institute for Transfusion Medicine, Pittsburgh, Pennsylvania
Search for more papers by this authorEdward L. Murphy
Blood Systems Research Institute, San Francisco, and Department of Laboratory Medicine, University of California, San Francisco, California
Search for more papers by this authorSteve Kleinman
University of British Columbia, Victoria, British Columbia, Canada
Search for more papers by this authorMark T. Gladwin
Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
Search for more papers by this authorMichael P. Busch
Blood Systems Research Institute, San Francisco, and Department of Laboratory Medicine, University of California, San Francisco, California
MPB and AEM contributed equally to the manuscript.Search for more papers by this authorAlan E. Mast
Blood Research Institute, Blood Center of Wisconsin, and Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee
MPB and AEM contributed equally to the manuscript.Search for more papers by this authorfor the NHLBI Recipient Epidemiology Donor Evaluation Study (REDS)-III Program
Search for more papers by this authorCorresponding Author
Tamir Kanias
Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
Address reprint requests to: Tamir Kanias, Vitalant Research Institute, 717 Yosemite Street, Denver, CO 80230; e-mail: [email protected]Search for more papers by this authorMars Stone
Blood Systems Research Institute, San Francisco, and Department of Laboratory Medicine, University of California, San Francisco, California
Search for more papers by this authorYuelong Guo
RTI International, Research Triangle Park, North Carolina
Search for more papers by this authorMarion C. Lanteri
Blood Systems Research Institute, San Francisco, and Department of Laboratory Medicine, University of California, San Francisco, California
Search for more papers by this authorBryan R. Spencer
American Red Cross Blood Services, Dedham, Massachusetts
Search for more papers by this authorDarrell J. Triulzi
Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania
The Institute for Transfusion Medicine, Pittsburgh, Pennsylvania
Search for more papers by this authorJoseph E. Kiss
The Institute for Transfusion Medicine, Pittsburgh, Pennsylvania
Search for more papers by this authorEdward L. Murphy
Blood Systems Research Institute, San Francisco, and Department of Laboratory Medicine, University of California, San Francisco, California
Search for more papers by this authorSteve Kleinman
University of British Columbia, Victoria, British Columbia, Canada
Search for more papers by this authorMark T. Gladwin
Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
Search for more papers by this authorMichael P. Busch
Blood Systems Research Institute, San Francisco, and Department of Laboratory Medicine, University of California, San Francisco, California
MPB and AEM contributed equally to the manuscript.Search for more papers by this authorAlan E. Mast
Blood Research Institute, Blood Center of Wisconsin, and Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee
MPB and AEM contributed equally to the manuscript.Search for more papers by this authorfor the NHLBI Recipient Epidemiology Donor Evaluation Study (REDS)-III Program
Search for more papers by this authorAbstract
BACKGROUND
Frequent whole blood donations increase the prevalence of iron depletion in blood donors, which may subsequently interfere with normal erythropoiesis. The purpose of this study was to evaluate the associations between donation frequency and red blood cell (RBC) storage stability in a racially/ethnically diverse population of blood donors.
STUDY DESIGN
Leukoreduced RBC concentrate–derived samples from 13,403 donors were stored for 39 to 42 days (1–6°C) and then evaluated for storage, osmotic, and oxidative hemolysis. Iron status was evaluated by plasma ferritin measurement and self-reported intake of iron supplements. Donation history in the prior 2 years was obtained for each subject.
RESULTS
Frequent blood donors enrolled in this study were likely to be white, male, and of older age (56.1 ± 5.0 years). Prior donation intensity was negatively associated with oxidative hemolysis (p < 0.0001) in multivariate analyses correcting for age, sex, and race/ethnicity. Increased plasma ferritin concentration was associated with increased RBC susceptibility to each of the three measures of hemolysis (p < 0.0001 for all), whereas self-reported iron intake was associated with reduced susceptibility to osmotic and oxidative hemolysis (p < 0.0001 for both).
CONCLUSIONS
Frequent blood donations may alter the quality of blood components by modulating RBC predisposition to hemolysis. RBCs collected from frequent donors with low ferritin have altered susceptibility to hemolysis. Thus, frequent donation and associated iron loss may alter the quality of stored RBC components collected from iron-deficient donors. Further investigation is necessary to assess posttransfusion safety and efficacy in patients receiving these RBC products.
CONFLICT OF INTEREST
DT serves as a paid consultant to Fresenius Kabi. AM receives research grant funding from Novo Nordisk. The remaining authors have disclosed no conflicts of interest.
Supporting Information
| Filename | Description |
|---|---|
| trf14998-sup-0001-supinfo.docxWord 2007 document , 4.5 MB |
Fig. S1. Race-ethnicity distributions of storage or stress-induced hemolysis at selected categories of donation frequency in prior 24 months. RBC concentrates from male or female donors ages 18–90 years old were stored (1–6°C) for 39 to 42 days in transfer bags and tested for storage or stress-induced hemolysis as described in Materials and Methods. (A) Percent AAPH-induced oxidative hemolysis (150 mmol/L, 1.5 h, 37°C) (n = 10,476). (B) Percent osmotic hemolysis (n = 12,799). (C) Percent spontaneous storage hemolysis (n = 12,753). Table S1. Percent storage, oxidative or osmotic hemolysis in each donation history category (0, 1–4, 5–8, and 9+) |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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