Impact of packed red blood cell transfusion on platelet activation and aggrega-tion in pediatric patients with cardiac disease

Miao Xiao-lei; Liu Jin-ping; Cui Yong-li; Zhao Ming-xia; Feng Zheng-yi; Zhao Ju; Long Cun; Li Shou-jun; Yan Fu-xia; Wang Xu

doi:10.13498/j.cnki.chin.j.ecc.2015.01.01

Abstract：Objective The aim of this study is to observe the impact of packed RBC transfusion on platelet activation and ag?gregation in vitro in pediatric patients with cardiac disease and to clarity whether circulating platelet microRNAs could be serve as a new indicator of platelet activation. Methods One hundred infant patients were randomly divided into 2 groups, transfusion group and non-transfusion group. Each group has 50 patients. In vitro transfusions were performed by the addition of RBC obtained from transfusion packs into fresh whole blood with a ratio about 1:4 (0.5 ml of RBC mixed with 1.8 ml of whole blood). After 30 min, the expression of P-selectin and the content of platelet microparticle (PMP) were tested by flow cytometry. Light transmission aggregometry was per?formed to determine the platelet aggregation. The expression levels of four kinds of circulation platelet microRNAs were detected by Taq?man quantitative real-time PCR. Results There were no significant difference in the baseline hemoglobin level between the two groups ( P>0. 05 ) . After RBC transfusion, the Hb level was elevated by 23 ± 6 g/L. Compared with non-transfusion group, platelet aggregation in transfusion group was significantly increased( P<0.05).Platelet activation was also increased by transfusion as confirmed by the elevation of P-selectin and PMP expressions induced by 20μM ADP. Similar results were found with the four kinds of circulat?ing platelet microRNAs ( P<0.05) . In the non-transfusion group, the levels of four kinds of microRNAs in the cyanotic subgroup were significantly elevated than the acyanotic subgroup( P<0.05) . Conclusion RBC transfusion increases in vitro platelet activation in pe?diatric patients with cardiac disease, providing a possible explanation for the increase in recurrent ischemic event and mortality reported after RBC transfusion in clinical practice. Circulation platelet microRNAs may serve as a new marker of platelet activation.