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Leukocyte filtration lesion impairs functional coagulation in banked whole blood

Overview of attention for article published in Journal of Trauma and Acute Care Surgery, The, September 2017
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Title
Leukocyte filtration lesion impairs functional coagulation in banked whole blood
Published in
Journal of Trauma and Acute Care Surgery, The, September 2017
DOI 10.1097/ta.0000000000001535
Pubmed ID
Authors

Anaar Siletz, Sigrid Burruss, Terry Gruber, Alyssa Ziman, Victor Marder, Henry Magill Cryer

Abstract

Whole blood (WB) transfusion is a promising alternative to component therapy in hemostatic resuscitation. Use of banked WB requires filtration of white blood cells (leukoreduction) and an established shelf life during which WB retains coagulant capacities. The goal of this study was to define the time course of coagulation stability in leukoreduced compared to unfiltered WB under standard refrigeration conditions. Twelve WB units were donated by healthy volunteers after routine screening. Five units underwent standard leukocyte filtration and five did not. Two units were aliquoted into filtered and unfiltered samples, with platelets added to each sample on Day 14. Units were stored at 4°C and sampled on days 0, 1, 2, 3, 4, 5, 6, 7, 10, 14, 21, 28, and 35 for immediate thromboelastogram (TEG) analysis, and centrifuged and stored at -80°C for later Calibrated Automated Thrombogram (CAT) and coagulation factor assays. K-dependent factors and fibrinogen were low normal, decreased slightly over 35 days, and were similar between unfiltered and filtered units. Labile factors were better preserved in filtered units, although unfiltered units did not show impaired coagulation over 35 days. Filtered blood had delayed clot initiation on days 0, 1, and 2 as measured by TEG R (p<0.021); slower clot progression (TEG α-angle) on days 0, 1, 2, 3, 4, 5, and 6 (p<0.023); weaker final clot (TEG MA) on all days (p<0.0001). Thrombin generation was delayed on day 28 (p=0.046) and decreased on days 10, 21, 28, and 35 (p<0.034). Addition of platelets to filtered WB rescued TEG MA. Filtered WB had decreased functional clotting capacity and thrombin generation and may not be suitable for hemostatic resuscitation as the sole blood product. Laboratory study.

Mendeley readers

The data shown below were compiled from readership statistics for 15 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 15 100%

Demographic breakdown

Readers by professional status Count As %
Other 3 20%
Student > Bachelor 3 20%
Student > Ph. D. Student 1 7%
Student > Master 1 7%
Researcher 1 7%
Other 0 0%
Unknown 6 40%
Readers by discipline Count As %
Medicine and Dentistry 4 27%
Biochemistry, Genetics and Molecular Biology 1 7%
Unspecified 1 7%
Immunology and Microbiology 1 7%
Business, Management and Accounting 1 7%
Other 0 0%
Unknown 7 47%