Tracking donor RBC survival in premature infants: agreement of multiple populations of biotin-labeled RBCs with Kidd antigen-mismatched RBCs

John A Widness, Demet Nalbant, Nell I Matthews, Ronald G Strauss, Robert L Schmidt, Gretchen A Cress, Miriam Bridget Zimmerman, Donald M Mock, John A Widness, Demet Nalbant, Nell I Matthews, Ronald G Strauss, Robert L Schmidt, Gretchen A Cress, Miriam Bridget Zimmerman, Donald M Mock

Abstract

Background: Anemia, a common condition among critically ill premature infants, is affected by red blood cell (RBC) survival (RCS). We hypothesized that transfused allogeneic Kidd antigen-mismatched RBCs would demonstrate the same concurrent RCS tracking as RBCs multilabeled at separate, discrete low densities with biotin (BioRBCs).

Methods: Allogeneic RBCs from adult donors were labeled at four biotin densities, mixed, and transfused into 17 anemic premature infants. Nine of the donors and neonates were Kidd antigen mismatched. Serial posttransfusion blood samples were assayed for up to 8 wk by flow cytometry to track the survival of the proportions of Kidd antigen-mismatched and Kidd antigen-biotinylated RBCs.

Results: Using linear mixed modeling to compare results, RCS of the three lowest BioRBC densities was similar to RCS by Kidd antigen mismatch and to one another. RCS of RBCs labeled at the highest BioRBC density was shortened.

Conclusion: RCS of different populations of RBCs can be tracked concurrently and reliably using the three lowest BioRBC densities. Although comparable RCS results can be achieved using Kidd antigen mismatches, BioRBCs are preferred for investigating neonatal anemia because biotin labeling of both allogeneic and autologous RBCs is possible.

Figures

Figure 1
Figure 1
Comparison of mean (± SEM) RBC survival tracking using: a) Kidd antigen donor-recipient mismatches as the reference control versus the four different BioRBC densities (n=9); and b) the lowest BioRBC density as the reference control versus the three higher BioRBC densities (n=17). The time of study for Panel a) is shorter because only data prior to the second RBC transfusion is included. x, Kidd Antigen (Ref); open circles, BioRBC 6 μg/ml; open triangles, BioRBC 18 μg/ml; open squares, BioRBC 54 μg/ml; open diamonds, BioRBC 162 μg/ml.
Figure 2
Figure 2
Agreement of HbF and Kidd antigen RBC tracking for selected individual infants following their first RBC transfusion: a) Infant 11 (see Table 1) HbF negative cells versus the 4 BioRBC densities; b) Infant 7 HbF negative cells versus the 4 BioRBC densities; c) Infant 15 Kidd Jka cells versus Kidd Jkb cells; and d) Infant 4 Kidd Jka cells versus Kidd Jkb cells. (a and b) Open circle, Kidd Jka; closed circle, Kidd Jkb; (c and 2d) x, HbF Neg RBCs; open circles, BioRBC 6 μg/ml; open triangles, BioRBC 18 μg/ml; open squares, BioRBC 54 μg/ml; open diamonds, BioRBC 162 μg/ml.

References

    1. Franco RS. The measurement and importance of red cell survival. Am J Hematol. 2009;84:109–14.
    1. Dancis J, Danoff S, Zabriskie J, Balis ME. Hemoglobin metabolism in the premature infant. J Pediatr. 1959;54:748–55.
    1. Garby L, Sjoelin S, Vuille JC. Studies on erythro-kinetics in infancy. V. Estimations of the life span of red cells in the newborn. Acta Paediatr. 1964;53:165–71.
    1. Wynn R, Dixon S, al-Ismail SA, et al. Flow cytometric determination of pre-transfusion red cell volume in fetuses and neonates requiring transfusion based on RhD+ dilution by transfused D- red cells. Br J Haematol. 1995;89:620–2.
    1. Hudson I, Cooke A, Holland B, et al. Red cell volume and cardiac output in anaemic preterm infants. Arch Dis Child. 1990;65:672–5.
    1. Phillips HM, Holland BM, Abdel-Moiz A, et al. Determination of red cell mass in assessment and management of anaemia in babies needing blood transfusion. Lancet. 1986;1:882–4.
    1. Klein HG, Anstee DJ. Mollison’s Blood Transfusion in Clinical Medicine. Oxford, U.K: Blackwell Publishing, Ltd; 2005. Appendix 7. Red cell survival methods based on antigenic differences between donor and recipient; pp. 850–1.
    1. Diekema DS. Conducting ethical research in pediatrics: a brief historical overview and review of pediatric regulations. J Pediatr. 2006;149:S3–11.
    1. Mock DM, Matthews NI, Zhu S, et al. Red blood cell (RBC) survival determined in humans using RBCs labeled at multiple biotin densities. Transfusion. 2011;51:1047–57.
    1. Arbuckle TE, Wilkins R, Sherman GJ. Birth weight percentiles by gestational age in Canada. Obstet Gynecol. 1993;81:39–48.
    1. Mock DM, Matthews NI, Zhu S, et al. Red blood cell (RBC) volume can be independently determined in vivo in humans using RBCs labeled at different densities of biotin. Transfusion. 2011;51:148–57.
    1. Strauss RG, Mock DM, Widness JA, Johnson K, Cress G, Schmidt RL. Posttransfusion 24-hour recovery and subsequent survival of allogeneic red blood cells in the bloodstream of newborn infants. Transfusion. 2004;44:871–6.
    1. Brugnara C, Platt OS. The neonatal erythrocyte and its disorders. In: Nathan DG, Oski FA, editors. Nathan and Oski’s Hematology of Infancy and Childhood. Philadelphia: W. B. Saunders Company, Inc; 2003. pp. 19–55.
    1. Dumont LJ, AuBuchon JP. Evaluation of proposed FDA criteria for the evaluation of radiolabeled red cell recovery trials. Transfusion. 2008;48:1053–60.
    1. Dumont LJ, AuBuchon JP BEST Collaborative. Evaluation of proposed FDA criteria for evaluation of radiolabeled red cell recovery trials. 2008 .
    1. Silver HM, Seebeck M, Carlson R. Comparison of total blood volume in normal, preeclamptic, and nonproteinuric gestational hypertensive pregnancy by simultaneous measurement of red blood cell and plasma volumes. Am J Obstet Gynecol. 1998;179:87–93.
    1. Recommended method for radioisotope red-cell survival studies. International Committee for Standardization in Haematology. Br J Haematol. 1980;45:659–66.
    1. Mock DM, Lankford GL, Widness JA, Burmeister LF, Kahn D, Strauss RG. Measurement of red cell survival using biotin labeled red cells: Validation against 51Cr labeled red cells. Transfusion. 1999;39:156–62.
    1. Mock DM, Lankford GL, Widness JA, Burmeister LF, Kahn D, Strauss RG. RBCs labeled at two biotin densities permit simultaneous and repeated measurements of circulating RBC volume. Transfusion. 2004;44:431–7.
    1. Cordle DG, Strauss RG, Lankford GL, Mock DM. Antibodies provoked by the transfusion of biotin-labeled red cells. Transfusion. 1999;39:1065–9.
    1. Mock DM, Widness JA, Strauss RG, Franco RS. Posttransfusion red blood cell (RBC) survival determined using biotin-labeled RBCs has distinct advantages over labeling with (51) Cr. Transfusion. 2012;52:1596–8.
    1. Freise KJ, Widness JA, Veng-Pedersen P. Erythropoietic response to endogenous erythropoietin in premature very low birth weight infants. J Pharmacol Exp Ther. 2010;332:229–37.
    1. Mock DM, Matthews NI, Strauss RG, Burmeister LF, Schmidt R, Widness JA. Red blood cell volume can be independently determined in vitro using sheep and human red blood cells labeled at different densities of biotin. Transfusion. 2009;49:1178–85.
    1. Mock DM, Matthews NI, Zhu S, et al. Red blood cell (RBC) volume can be independently determined in vivo in the sheep using ovine RBCs labeled at different densities of biotin. Transfusion. 2010;50:2553–64.
    1. Davis BH, Olsen S, Bigelow NC, Chen JC. Detection of fetal red cells in fetomaternal hemorrhage using a fetal hemoglobin monoclonal antibody by flow cytometry. Transfusion. 1998;38:749–56.

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