Red Blood Cell (RBC) Survival Following Transfusion in Infants

Summary

OUR OVERALL HYPOTHESIS is that post-transfusion survival of allogeneic and autologous RBCs can be accurately quantified in anemic human infants using biotin-labeled RBCs combined with mathematical modeling that adjusts for confounding factors commonly encountered in neonates. These confounding factors include 1) dilution of labeled RBC as a result of growth stimulated erythropoiesis, anemia stimulated erythropoiesis, and blood transfusion; 2) loss of labeled RBC due to laboratory phlebotomy; and 3) variable RBC life spans resulting from RBCs having been produced at different developmental periods and under varying rates of erythropoiesis. In contrast to infants, adjustment for these factors is not necessary in healthy adults under conditions of steady state erythropoiesis. Instead in adults, RBC survival is typified by a linear decline in concentration of labeled RBCs over time. When this line is extrapolated to zero concentration, the intercept with the time axis represents the mean potential lifespan (MPL) of RBCs. (\<7 d) and stored (\>21 d) allogeneic adult RBCs transfused in the same infant.

Timeline

Start

2008-06

Primary completion

2017-03

Completion

2018-03-02

Publications

• Results 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 Jun;49(6):1178-85. doi: 10.1111/j.1537-2995.2009.02095.x. Epub 2009 Feb 10.
• Results Mock DM, Matthews NI, Zhu S, Burmeister LF, Zimmerman MB, Strauss RG, Schmidt RL, Nalbant D, Cress GA, Widness JA. Red blood cell (RBC) volume can be independently determined in vivo in humans using RBCs labeled at different densities of biotin. Transfusion. 2011 Jan;51(1):148-57. doi: 10.1111/j.1537-2995.2010.02770.x.
• Results Mock DM, Matthews NI, Zhu S, Strauss RG, Schmidt RL, Nalbant D, Cress GA, Widness JA. Red blood cell (RBC) survival determined in humans using RBCs labeled at multiple biotin densities. Transfusion. 2011 May;51(5):1047-57. doi: 10.1111/j.1537-2995.2010.02926.x. Epub 2010 Nov 9.
• Results Mock DM, Lankford GL, Matthews NI, Burmeister LF, Kahn D, Widness JA, Strauss RG. Accelerated removal of antibody-coated red blood cells from the circulation is accurately tracked by a biotin label. Transfusion. 2012 May;52(5):1097-105. doi: 10.1111/j.1537-2995.2011.03397.x. Epub 2011 Oct 24.
• Results 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 Jul;52(7):1596-8. doi: 10.1111/j.1537-2995.2012.03588.x. No abstract available.
• Results Nalbant D, Bhandary P, Matthews NI, Schmidt RL, Bogusiewicz A, Cress GA, Zimmerman MB, Strauss RG, Mock DM, Widness JA. Comparison of multiple red cell volume methods performed concurrently in premature infants following allogeneic transfusion. Pediatr Res. 2013 Nov;74(5):592-600. doi: 10.1038/pr.2013.143. Epub 2013 Sep 3.
• Results Widness JA, Nalbant D, Matthews NI, Strauss RG, Schmidt RL, Cress GA, Zimmerman MB, Mock DM. Tracking donor RBC survival in premature infants: agreement of multiple populations of biotin-labeled RBCs with Kidd antigen-mismatched RBCs. Pediatr Res. 2013 Dec;74(6):689-97. doi: 10.1038/pr.2013.163. Epub 2013 Sep 4.
• Results Widness JA, Kuruvilla DJ, Mock DM, Matthews NI, Nalbant D, Cress GA, Schmidt RL, Strauss RG, Zimmerman MB, Veng-Pedersen P. Autologous Infant and Allogeneic Adult Red Cells Demonstrate Similar Concurrent Post-Transfusion Survival in Very Low Birth Weight Neonates. J Pediatr. 2015 Nov;167(5):1001-6. doi: 10.1016/j.jpeds.2015.08.028. Epub 2015 Sep 9.
• Results Schmidt RL, Mock DM, Franco RS, Cohen RM, North AK, Cancelas JA, Geisen C, Strauss RG, Vlaar AP, Nalbant D, Widness JA. Antibodies to biotinylated red blood cells in adults and infants: improved detection, partial characterization, and dependence on red blood cell-biotin dose. Transfusion. 2017 Jun;57(6):1488-1496. doi: 10.1111/trf.14075. Epub 2017 Mar 5.
• Nalbant D, Cancelas JA, Mock DM, Kyosseva SV, Schmidt RL, Cress GA, Zimmerman MB, Strauss RG, Widness JA. In premature infants there is no decrease in 24-hour posttransfusion allogeneic red blood cell recovery after 42 days of storage. Transfusion. 2018 Feb;58(2):352-358. doi: 10.1111/trf.14396. Epub 2017 Nov 29.

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