thromboplastin and Transfusion-Reaction

Topics: Bleeding Time; Blood Coagulation; Blood Coagulation Disorders; Clinical Laboratory Techniques; Disseminated Intravascular Coagulation; Fibrinolysis; Humans; Mass Screening; Partial Thromboplastin Time; Risk Factors; Thromboplastin; Transfusion Reaction; Vitamin K

The pathomechanisms of morbidity due to blood transfusions are not yet entirely understood. Elevated levels of red blood cell-derived microparticles (RMPs) are found in coagulation-related pathologies and also in stored blood. Previous research has shown that RMPs mediate transfusion-related complications by the intrinsic pathway. We hypothesized that RMPs might play a role in post-transfusion thrombotic complications by enhancing procoagulant activity also through the extrinsic pathway of coagulation.. In this laboratory study, blood from 18 healthy volunteers was stimulated with microparticles from expired stored red blood cells. Various clotting parameters were recorded. Flow cytometry, enzyme-linked immunosorbent assays, and real-time polymerase chain reaction were used to investigate possible mediating mechanisms.. The addition of RMPs shortened the clotting time from 194 to 161 seconds (p < 0.001). After incubation with RMPs, there was increased expression of tissue factor (TF) on monocytes and in plasma. TF messenger RNA expression increased in a time-dependent and concentration-dependent manner. There was a significant induction of interleukin-1β and interleukin-6. After stimulation with RMPs, there was a significant increase in the number of activated platelets, an increased percentage of PAC-1/CD62P (procaspase activating compound-1/platelet surface P-selectin) double-positive platelets, and an increased number of platelet-neutrophil duplets and platelet-monocyte duplets, indicating enhanced interaction of platelets with neutrophils and monocytes. Levels of CXCL-8 (C-X-C motif chemokine ligand 1) and interleukin-6 were significantly higher after treatment with RMPs.. Our results suggest that RMPs trigger coagulation through TF signaling, induce the secretion of proinflammatory cytokines, and induce cell-cell interaction between platelets and neutrophils. Thus, under certain conditions, RMPs could play a role in post-transfusion complications through these mechanisms.

Topics: Blood Coagulation; Blood Preservation; Cell Communication; Cell-Derived Microparticles; Erythrocytes; Humans; Inflammation; Interleukin-6; Interleukin-8; Monocytes; Platelet Activation; RNA, Messenger; Thromboplastin; Thrombosis; Transfusion Reaction

Blood dilution is a frequent complication of massive transfusion during trauma and surgery. This article investigates the quantitative effects of blood plasma dilution on thrombin generation in the context of intersubject variability.. A thoroughly validated computational model was used to simulate thrombin generation curves for 472 healthy subjects in the Leiden Thrombophilia Study. Individual thrombin curves were calculated for undiluted blood and for different dilution scenarios. For every such curve, five standard quantitative parameters of thrombin generation were calculated and analyzed.. Thrombin generation parameters in diluted blood plasma displayed significant intersubject variability (with a coefficient of variation up to approx. 28%). Nevertheless, dilutional effects in the majority (or all) of the subjects in the study group were characterized by persistent patterns. In particular, the largest dilution-induced change typically occurred in the maximum slope (MS) of the thrombin curve, followed by a change in thrombin peak height (PH), whereas the smallest change often occurred in the area under the curve. The identified patterns demonstrated considerable robustness to variations in dilution scenario and tissue factor concentration.. Dilutional effects on thrombin generation in a human population can be predicted from trends identified for the "average" subject and then refined by performing an analysis of actual subjects in the study group. The MS and PH are dilution indicators that are both sensitive and reliable across a large subject group and could potentially be used as disease markers in the diagnosis of coagulopathic conditions.

Topics: Blood Coagulation; Blood Coagulation Disorders; Blood Coagulation Factors; Computer Simulation; Hemodilution; Humans; Models, Biological; Predictive Value of Tests; Resuscitation; Thrombin; Thromboplastin; Transfusion Reaction

TRALI may be a severe reaction associated with transfusion of plasma-containing blood components. TRALI has usually been associated with antibodies against granulocytes and HLA class I antigens, but more recently with antibodies against HLA class II and monocytes. TRALI cases were investigated to determine correlation between antigen and antibody. Additionally, activation of monocytes by TRALI serums was studied.. Sixteen cases of TRALI were investigated. All patients were typed for HLA antigens. Implicated donors were screened for HLA antigens and antibodies against granulocytes and monocytes. In 6 cases, recipient monocyte activation was measured in vitro after incubation with TRALI and control serums. In four cases, monocyte activation was measured after incubation of TRALI serums against a panel of monocytes of known HLA antigen type.. In 14 of the 16 cases (87.5%), antigen-antibody correlation was identified. TRALI monocytes, incubated with implicated TRALI serum (n = 6), expressed significantly greater cytokine and tissue factor (p < 0.05, repeated-measures ANOVA) than controls. Panel monocytes incubated with TRALI serum showed increased expression of cytokine and/or tissue factor when corresponding antigen was present.. In most cases of TRALI, a correlation between antigen and antibody can be identified. Activation of monocytes and their subsequent release of cytokines may play a role in the pathogenesis of TRALI.

Topics: Blood Donors; Cytokines; Female; Granulocytes; Histocompatibility Antigens Class I; Histocompatibility Antigens Class II; Histocompatibility Testing; Humans; Isoantibodies; Isoantigens; Male; Monocytes; Respiratory Distress Syndrome; Thromboplastin; Transfusion Reaction

Topics: Blood Coagulation Disorders; Blood Coagulation Tests; Factor V; Factor VIII; Factor XIII; Fibrinogen; Humans; Microcirculation; Prothrombin; Thromboplastin; Thrombosis; Toxins, Biological; Transfusion Reaction

Topics: Blood Platelet Disorders; Blood Preservation; Freezing; Hemorrhage; Humans; Male; Military Medicine; Prothrombin Time; Thromboplastin; Transfusion Reaction

Topics: Animals; Anticoagulants; Blood Coagulation Disorders; Blood Vessels; Dogs; Fibrinolysis; Hematologic Diseases; Hemorrhage; Hemostasis; Humans; Postoperative Complications; Rabbits; Rats; Stress, Physiological; Stress, Psychological; Surgical Procedures, Operative; Thromboplastin; Transfusion Reaction