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J Surg Res. 2018 Feb;222:26-33. doi: 10.1016/j.jss.2017.09.017. Epub 2017 Oct 28.

Preischemic transfusion of old packed RBCs exacerbates early-phase warm hepatic ischemia reperfusion injury in rats.

Author information

1
Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine, Daegu, Korea.
2
Department of Biochemistry and Molecular Biology, Yeungnam University College of Medicine, Daegu, Korea.
3
Department of Pathology, Yeungnam University College of Medicine, Daegu, Korea.
4
Department of Laboratory Medicine, Yeungnam University College of Medicine, Daegu, Korea.
5
Department of Anatomy, Yeungnam University College of Medicine, Daegu, Korea.
6
Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine, Daegu, Korea. Electronic address: dljee@ynu.ac.kr.

Abstract

BACKGROUND:

Hepatic innate immune cells are considered to play a central role in the early phase of hepatic ischemia reperfusion (IR) injury. Transfusion of old red blood cells (RBCs) is known to prime immune cells, and transfusion before IR may exacerbate liver injury because of the expected hyperresponsiveness of immune cells.

MATERIALS AND METHODS:

Twenty-four Sprague-Dawley rats were divided into four groups: sham operation (Sham); hepatic IR only (IR Control); and two transfusion groups, preischemic (Pre-T) and postischemic (Post-T), in which allogeneic RBCs stored for 2 weeks were transfused before hepatic IR or after reperfusion, respectively. Partial hepatic ischemia was induced for 90 min, and reperfusion was allowed for 120 min. Serum alanine transaminase levels, area of necrosis, and apoptotic cells were then assessed. Inflammatory (tumor necrosis factor alpha, interleukin 1 beta [IL-1β], IL-6, IL-10, and cyclooxygenase 2) and oxidative mediators (heme oxygenase 1, superoxide dismutase, and glutathione peroxidase 1) were assessed for elucidating the relevant mechanisms underlying the hepatic injury.

RESULTS:

Pre-T, but not Post-T, showed increased serum alanine transaminase levels than IR Control (P < 0.05). Area of necrosis was more severe in Pre-T than in IR Control or Post-T (P < 0.01), and apoptotic cells were also more abundant in Pre-T than in IR Control (P < 0.01). tumor necrosis factor alpha and IL-6 levels were higher in Pre-T than in IR Control or Post-T (P < 0.05), with no significant difference in cytoprotective protein levels.

CONCLUSIONS:

Preischemic transfusion of old RBCs aggravated hepatic injury. Inflammatory cytokines seemed to play a crucial role in liver injury exacerbation. Our results indicate that transfusion before hepatic ischemia may be detrimental.

KEYWORDS:

Blood transfusion; Hepatic ischemia reperfusion; Inflammation; Liver injury

PMID:
29273372
DOI:
10.1016/j.jss.2017.09.017
[Indexed for MEDLINE]

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