Document Detail


Resuscitation with aged blood exacerbates liver injury in a hemorrhagic rat model.
MedLine Citation:
PMID:  23314580     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Blood loss and transfusion are frequent among patients undergoing liver surgery. Concerns have been raised about the safety and efficacy of transfusing stored blood. The influence of transfusing fresh vs. stored blood on the liver has not been studied to date. We tested the hypothesis that transfusion of stored, but not fresh blood, adversely affects liver outcome in vivo following acute hemorrhage. Additionally, possible mechanisms linking adverse liver outcome with increased storage duration were evaluated.
DESIGN: Prospective, controlled, animal study.
SETTING: University research laboratory.
SUBJECTS: Adult male Sprague-Dawley rats
INTERVENTIONS: Anesthetized rats were randomized to control, hemorrhagic and shock group (acute bleeding; HSG), or hemorrhagic and blood resuscitation groups (BR) (with fresh blood [BR-d0], blood stored for 4 [BR-d4] or 7 [BR-d7] days, or packed RBCs stored for 7 days [packed RBC-d7]).
MEASUREMENTS AND MAIN RESULTS: Administration of blood or packed RBC stored for 7 days exacerbated liver injury as reflected by liver necrosis and enhanced apoptosis (p < 0.001). Functional MRI analysis of the liver demonstrated significant improvement in liver perfusion with fresh blood (% change in functional MRI signal intensity due to hyperoxia was 16% ± 3% in BR-d0 vs. 4% ± 3% in hemorrhagic group, p < 0.001) but not with stored blood (12% ± 2% and 9% ± 5% for BR-d4 and BR-d7, respectively). Analysis of stored blood showed reduction in RBC deformability at 7 days of storage, reflecting a five-fold increase in the number of undeformable cells.
CONCLUSION: Liver injury is exacerbated by the transfusion of stored blood, primarily due to the change in the rheological properties of RBC. This data call for clinical studies in patients undergoing liver resection or transplantation.
Authors:
Idit Matot; Miriam Katz; Orit Pappo; Orly Zelig; Nathalie Corchia; Shaul Yedgar; Gregory Barshtein; Elliot Bennett-Guerrero; Elliot Bennett Guerrero; Rinat Abramovitch
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  41     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-21     Completed Date:  2013-04-16     Revised Date:  2013-05-06    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  842-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology & Intensive Care, Tel-Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel.
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MeSH Terms
Descriptor/Qualifier:
Animals
Apoptosis
Blood Preservation / adverse effects*
Disease Models, Animal*
Erythrocyte Deformability
Erythrocyte Transfusion / adverse effects*
Liver / injuries*,  pathology,  surgery
Magnetic Resonance Imaging
Male
Prospective Studies
Random Allocation
Rats
Rats, Sprague-Dawley
Shock, Hemorrhagic / therapy*
Comments/Corrections
Comment In:
Crit Care Med. 2013 Mar;41(3):928-9   [PMID:  23425834 ]
Erratum In:
Crit Care Med. 2013 Apr;41(4):e41
Note: Guerrero, Elliot Bennett [corrected to Bennett-Guerrero, Elliot]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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