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<p>Transfusion of Packed RBC units (PRBC) in multi-transfused patients often results in a progressive rise in transfusion requirements. To evaluate the procoagulant potential of PRBC in multi-transfused patients. We conducted this prospective cohort study (2020–2022) on multi-transfused patients (n = 31) having a lifetime transfusion of ≧ 4 units PRBCs. Biochemical parameters pre-, post-transfusion (≤ 24 hours) samples included, highly sensitive C reactive protein (HsCRP) for inflammation, LDH for hemolysis, tissue plasminogen activator (tPA), Antithrombin 3 (ATIII) levels as coagulopathy, anti-hemostatic marker and blood microparticle (MPs) (flowcytometry) as Annexin 5+ (AV+) events for TF. We performed Wilcoxon signed rank test (P≤ 0.05), pre-, posttransfusion (P≤ 0.05) and association pre- and posttransfusion by Spearman’s rho correlation coefficient (CC), Linear regression (r<sup>2</sup>). Median (95% CI; P≤ 0.05) biochemical parameters pre-, posttransfusion, tPA {7.88 (2.63–20.44); 14.40 (5.29–27.08)} (P = 0.012) and ATIII {1299.66 (1078.5–1362.5); 1358.92 (1216 -1384.3)} (P = 0.011) respectively. A pre-, posttransfusion comparison of HsCRP (P = 0.45); LDH (P = 0.87) and MPs (number of events) (P = 0.54) pre-, posttransfusion were not significantly different. We observed a significant CC pre-posttransfusion HsCRP (0.61, P &lt; 0.01); ATIII (0.480, P = 0.006); tPA (0.807, P &lt; 0.01); MPs (0.625, P &lt; 0.004) and r<sup>2</sup> tPA (posttransfusion) (dependent variable) tPA (pre-transfusion), ATIII (pre-transfusion) (predictor variables) r<sup>2</sup> = 0.85 (P &lt; 0.01); ATIII (posttransfusion) (dependent variable) and ATIII (pre-transfusion); LDH (pre-transfusion) (predictor variable) r<sup>2</sup> = 0.45 (P = 0.026). A significant differences tPA, ATIII (pre-posttransfusion) and an association ‘pre-posttransfusion’ may be attributed to PRBC transfusions. tPA levels with corresponding changes in ATIII indicate coagulopathic response, following PRBC transfusions.</p>

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To Estimate the Coagulopathy Potential of Packed RBC Transfusions in Multi-Transfused Patients: A Prospective Cohort Study

  • 期刊论文

  • 发表日期：

    2025年2月6日

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  • Sankalp Sharma,
  • Suprava Patel,
  • Vinay Pandit,
  • N. Tirunelvely,
  • Sunil Jondhale,
  • Mili Patel,
  • Ankit Jain,
  • Pankaj Yadav

摘要

Transfusion of Packed RBC units (PRBC) in multi-transfused patients often results in a progressive rise in transfusion requirements. To evaluate the procoagulant potential of PRBC in multi-transfused patients. We conducted this prospective cohort study (2020–2022) on multi-transfused patients (n = 31) having a lifetime transfusion of ≧ 4 units PRBCs. Biochemical parameters pre-, post-transfusion (≤ 24 hours) samples included, highly sensitive C reactive protein (HsCRP) for inflammation, LDH for hemolysis, tissue plasminogen activator (tPA), Antithrombin 3 (ATIII) levels as coagulopathy, anti-hemostatic marker and blood microparticle (MPs) (flowcytometry) as Annexin 5+ (AV+) events for TF. We performed Wilcoxon signed rank test (P≤ 0.05), pre-, posttransfusion (P≤ 0.05) and association pre- and posttransfusion by Spearman’s rho correlation coefficient (CC), Linear regression (r2). Median (95% CI; P≤ 0.05) biochemical parameters pre-, posttransfusion, tPA {7.88 (2.63–20.44); 14.40 (5.29–27.08)} (P = 0.012) and ATIII {1299.66 (1078.5–1362.5); 1358.92 (1216 -1384.3)} (P = 0.011) respectively. A pre-, posttransfusion comparison of HsCRP (P = 0.45); LDH (P = 0.87) and MPs (number of events) (P = 0.54) pre-, posttransfusion were not significantly different. We observed a significant CC pre-posttransfusion HsCRP (0.61, P < 0.01); ATIII (0.480, P = 0.006); tPA (0.807, P < 0.01); MPs (0.625, P < 0.004) and r2 tPA (posttransfusion) (dependent variable) tPA (pre-transfusion), ATIII (pre-transfusion) (predictor variables) r2 = 0.85 (P < 0.01); ATIII (posttransfusion) (dependent variable) and ATIII (pre-transfusion); LDH (pre-transfusion) (predictor variable) r2 = 0.45 (P = 0.026). A significant differences tPA, ATIII (pre-posttransfusion) and an association ‘pre-posttransfusion’ may be attributed to PRBC transfusions. tPA levels with corresponding changes in ATIII indicate coagulopathic response, following PRBC transfusions.