Advances in Transfusion Medicine for Veterinary Patients
Abstract
Red blood cell (RBC) transfusions are common life-saving treatments for hypoxic
anemia both for human and veterinary patients. For many years, allogenic blood transfusion
(ABT) was the mainstay of transfusion medicine due to efficacy and relative availability,
especially perioperatively and in emergency trauma cases. However, ABTs are no longer the
preferred treatment for anemia in human and veterinary medicine. There has been a shift away
from liberal or unnecessary transfusions due to the inherent risks, and a new focus on more
conservative protocols using patient blood management. Similarly, in veterinary medicine, there
has been an increase in awareness of risks associated with ABT and adoption of more
conservative transfusion principles.
Alternative transfusion methods have been explored to reduce the need for ABT
perioperatively. Specifically, autologous blood transfusion (autotransfusion) via cell salvage
washing (CSW) is an effective, safe alternative used perioperatively without risk of
incompatibility. However, contraindications have limited the use of cell salvage in the past.
Leukoreduction filters (LRF) have been investigated to mitigate such contraindications by
removing contaminants, specifically bacteria. LRF has proven effective to remove bacteria in
human blood. Our proof-of-concept study showed that CSW in combination with LRF reduced
bacterial contamination in dog blood. Therefore, CSW and LRF could be used to remove
bacterial contamination of blood for intraoperative autotransfusion in veterinary patients.
Despite our best efforts, ABT cannot always be avoided. A major component of ABT that
contributes to transfusion-associated complications is storage lesion. Storage lesions and
secondary detrimental effects on patient outcome have been well described in the literature.
Microparticles (MPs) derived from blood cells have been identified in stored ABT and are
considered a storage lesion. Prestorage leukoreduction has been shown to decrease, not
eliminate, the formation of MPs. Prestorage leukoreduction is a standard transfusion protocol in
human medicine but not veterinary medicine. Therefore, we investigated the ability of a LRF to
remove MPs from stored dog blood prior to transfusion. We concluded that the LRF used in this
study did not remove MPs from stored dog blood post-storage. However, based on the
limitations, further studies are indicated to validate this conclusion.
Subject
Allogenic blood transfusionAutologous blood transfusion
Autotransfusion
Cell salvage
Red blood cell transfusion
Transfusion reaction
Transfusion-related immunomodulation
Transfusion-associated lung injury
Leukoreduction
Prestorage leukoreduction
Leukoreduction filter
Leukocyte reduction filter
Bacterial contamination
Bacteria removal
Decontamination
Storage lesion
Microparticles
Microparticle quantification
Microparticle phenotyping
Flow cytometry
Antibody labeling
Erythrocyte-derived microparticles
Leukocyte-derived microparticles
Platelet-derived microparticles
Canine
Veterinary medicine
Veterinary transfusion medicine
Citation
Hinson, Whitney Danielle (2018). Advances in Transfusion Medicine for Veterinary Patients. Master's thesis, Texas A & M University. Available electronically from https : / /hdl .handle .net /1969 .1 /173650.
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