Skip to main content

Effects of repleting organic phosphates in banked erythrocytes on plasma metabolites and vasoactive mediators after red cell exchange transfusion in sickle cell disease.

Publication ,  Journal Article
Lopez Domowicz, DA; Welsby, I; Esther, CR; Zhu, H; Marek, RD; Lee, G; Shah, N; Poisson, JL; McMahon, TJ
Published in: Blood transfusion = Trasfusione del sangue
May 2020

Red blood cell (RBC) exchange (RCE) transfusion therapy is indicated for certain patients with sickle cell disease (SCD). Although beneficial, this therapy is costly and inconvenient to patients, who may require it monthly or more often. Identification of blood and plasma biomarkers that could improve or help individualise RCE therapy is of interest. Here we examined relevant blood and plasma metabolites and biomarkers of vasoactivity and RBC fragility in a pilot study of SCD patients undergoing RCE using either standard RBC units or RBC units treated with a US Food and Drug Administration (FDA)-approved additive solution containing phosphate, inosine, pyruvate, and adenine ("PIPA").In this prospective, single-blind, cross-over pilot clinical trial, patients were randomised to receive either standard RBC exchange or PIPA-treated RBC exchange transfusion with each RCE session over a 6-month treatment period. Pre- and post-transfusion blood samples were obtained and analysed for RBC O2 affinity, ATP, purine metabolites, RBC microparticles, and cell free haemoglobin.Red blood cell O2 affinity was maintained after PIPA-RCE in contrast to standard RCE, after which P50 fell (net O2 affinity rose). Plasma ATP did not change significantly after RCE using either of the RBC unit types. Exchange transfusion with PIPA-treated RBC units led to modest increases in plasma inosine and hypoxanthine. Plasma cell free haemoglobin fell after either standard or PIPA-treated RBC exchange transfusion (novel findings), and to a similar extent. RBC-derived microparticles in the plasma fell significantly and similarly after both standard and PIPA-treated RCE transfusion.In summary, treatment of RBCs with PIPA prior to RCE elicited favourable or neutral changes in key metabolic and vascular biomarkers. Further study of its efficacy and safety is recommended and could ultimately serve to improve outcomes in chronically transfused SCD patients.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Blood transfusion = Trasfusione del sangue

DOI

EISSN

2385-2070

ISSN

1723-2007

Publication Date

May 2020

Volume

18

Issue

3

Start / End Page

200 / 207

Related Subject Headings

  • Prospective Studies
  • Plasma
  • Pilot Projects
  • Male
  • Humans
  • Erythrocyte Transfusion
  • Cross-Over Studies
  • Blood Preservation
  • Anemia, Sickle Cell
  • Adult
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Lopez Domowicz, D. A., Welsby, I., Esther, C. R., Zhu, H., Marek, R. D., Lee, G., … McMahon, T. J. (2020). Effects of repleting organic phosphates in banked erythrocytes on plasma metabolites and vasoactive mediators after red cell exchange transfusion in sickle cell disease. Blood Transfusion = Trasfusione Del Sangue, 18(3), 200–207. https://doi.org/10.2450/2020.0237-19
Lopez Domowicz, Denise A., Ian Welsby, Charles R. Esther, Hongmei Zhu, Robert D. Marek, Grace Lee, Nirmish Shah, Jessica L. Poisson, and Tim J. McMahon. “Effects of repleting organic phosphates in banked erythrocytes on plasma metabolites and vasoactive mediators after red cell exchange transfusion in sickle cell disease.Blood Transfusion = Trasfusione Del Sangue 18, no. 3 (May 2020): 200–207. https://doi.org/10.2450/2020.0237-19.
Lopez Domowicz DA, Welsby I, Esther CR, Zhu H, Marek RD, Lee G, et al. Effects of repleting organic phosphates in banked erythrocytes on plasma metabolites and vasoactive mediators after red cell exchange transfusion in sickle cell disease. Blood transfusion = Trasfusione del sangue. 2020 May;18(3):200–7.
Lopez Domowicz, Denise A., et al. “Effects of repleting organic phosphates in banked erythrocytes on plasma metabolites and vasoactive mediators after red cell exchange transfusion in sickle cell disease.Blood Transfusion = Trasfusione Del Sangue, vol. 18, no. 3, May 2020, pp. 200–07. Epmc, doi:10.2450/2020.0237-19.
Lopez Domowicz DA, Welsby I, Esther CR, Zhu H, Marek RD, Lee G, Shah N, Poisson JL, McMahon TJ. Effects of repleting organic phosphates in banked erythrocytes on plasma metabolites and vasoactive mediators after red cell exchange transfusion in sickle cell disease. Blood transfusion = Trasfusione del sangue. 2020 May;18(3):200–207.

Published In

Blood transfusion = Trasfusione del sangue

DOI

EISSN

2385-2070

ISSN

1723-2007

Publication Date

May 2020

Volume

18

Issue

3

Start / End Page

200 / 207

Related Subject Headings

  • Prospective Studies
  • Plasma
  • Pilot Projects
  • Male
  • Humans
  • Erythrocyte Transfusion
  • Cross-Over Studies
  • Blood Preservation
  • Anemia, Sickle Cell
  • Adult