Rapid clearance of storage-induced microerythrocytes alters transfusion recovery
Camille Roussel, Alexandre Morel, Michaël Dussiot, Mickaël Marin, Martin Colard, Aurélie Fricot-Monsinjon, Anaïs Martinez, Charlotte Chambrion, Benoît Henry, Madeleine Casimir, Geoffroy Volle, Mallorie Dépond, Safi Dokmak, François Paye, Alain Sauvanet, Caroline Le Van Kim, Yves Colin, Sonia Georgeault, Philippe Roingeard, Steven L Spitalnik, Papa Alioune Ndour, Olivier Hermine, Eldad A Hod, Pierre A Buffet, Pascal Amireault, Camille Roussel, Alexandre Morel, Michaël Dussiot, Mickaël Marin, Martin Colard, Aurélie Fricot-Monsinjon, Anaïs Martinez, Charlotte Chambrion, Benoît Henry, Madeleine Casimir, Geoffroy Volle, Mallorie Dépond, Safi Dokmak, François Paye, Alain Sauvanet, Caroline Le Van Kim, Yves Colin, Sonia Georgeault, Philippe Roingeard, Steven L Spitalnik, Papa Alioune Ndour, Olivier Hermine, Eldad A Hod, Pierre A Buffet, Pascal Amireault
Abstract
Permanent availability of red blood cells (RBCs) for transfusion depends on refrigerated storage, during which morphologically altered RBCs accumulate. Among these, a subpopulation of small RBCs, comprising type III echinocytes, spheroechinocytes, and spherocytes and defined as storage-induced microerythrocytes (SMEs), could be rapidly cleared from circulation posttransfusion. We quantified the proportion of SMEs in RBC concentrates from healthy human volunteers and assessed correlation with transfusion recovery, investigated the fate of SMEs upon perfusion through human spleen ex vivo, and explored where and how SMEs are cleared in a mouse model of blood storage and transfusion. In healthy human volunteers, high proportion of SMEs in long-stored RBC concentrates correlated with poor transfusion recovery. When perfused through human spleen, 15% and 61% of long-stored RBCs and SMEs were cleared in 70 minutes, respectively. High initial proportion of SMEs also correlated with high retention of RBCs by perfused human spleen. In the mouse model, SMEs accumulated during storage. Transfusion of long-stored RBCs resulted in reduced posttransfusion recovery, mostly due to SME clearance. After transfusion in mice, long-stored RBCs accumulated predominantly in spleen and were ingested mainly by splenic and hepatic macrophages. In macrophage-depleted mice, splenic accumulation and SME clearance were delayed, and transfusion recovery was improved. In healthy hosts, SMEs were cleared predominantly by macrophages in spleen and liver. When this well-demarcated subpopulation of altered RBCs was abundant in RBC concentrates, transfusion recovery was diminished. SME quantification has the potential to improve blood product quality assessment. This trial was registered at www.clinicaltrials.gov as #NCT02889133.
Conflict of interest statement
Conflict-of-interest disclosure: P.A.B. and P.A. are funded in part by Zimmer Biomet. The remaining authors declare no competing financial interests.
© 2021 by The American Society of Hematology.
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Source: PubMed