Optimization of biotinylation protocol for next generation studies of red blood cell survival after transfusion

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BACKGROUND: Red blood cell (RBC) biotinylation has increasingly become the preferred method for quantifying RBC post-transfusion recovery (PTR). This study evaluated the feasibility of transfusing autologous RBCs labeled with biotin (BioRBCs) 48 h prior to transfusion. The rationale was to facilitate the distribution of BioRBC products from manufacturing sites to remote clinical sites. STUDY DESIGN: Leukocyte-reduced RBC units from 12 healthy individuals were stored at 1-6°C for 42 days and biotinylated with two biotin densities (3 and 15 μg/mL) 48 and 4 h prior to transfusion. Each individual was transfused with 10 mL of each BioRBC preparation, after which BioRBC 20 h PTR and long-term survival (30 and 90 days) were determined by flow cytometric analyses. Additional quality measurements included phosphatidylserine (PS) exposure on BioRBCs and in vitro metrics of hemolysis. RESULTS: RBC transfusion 48 h after biotinylation was not associated with altered BioRBC 20 h PTR or 30 and 90 day survival as compared with RBC transfusion 4 h after biotinylation (e.g., PTR 20 h: 85.7% ± 8.4% vs. 87.5% ± 7.3%; 48 and 4 h, respectively, p > .05). Similarly, no significant differences between the BioRBC groups were observed in BioRBC PS exposure at all time points. BioRBC long-term survival, but not 20 h PTR, was negatively associated with donor hemoglobin (Pearson r = -0.71, p = .001) and osmotic hemolysis (r = -0.783, p = .003). None of the participants developed antibodies against BioRBCs during the trial. CONCLUSIONS: RBC biotinylation 48 h prior to transfusion does not compromise the quality and safety of BioRBC products. BioRBC long-term survival can be used to identify donor characteristics that influence RBC lifespan in the circulation.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.