Background: Packed Red Cells (PRC) is one of the blood component obtained from the whole blood through the removal of blood plasma. The storage of PRC aims to maintain the viability and function of erythrocytes by reducing cell metabolic activity. However, PRC's biochemistry changes could occur through storage lesion by releasing Stromal Cell-Derived Factor 1 (SDF-1) and Transforming Growth Factor-Beta 1 (TGF-?1) that affect the erythrocytes metabolism and viability prior to transfusion. This study aims to evaluate the increase of SDF-1 and TGF-?1 levels in PRC as the indicator of storage lesion at Sanglah Hospital-Blood Bank, Bali, Indonesia.
Methods: An observational cross-sectional study using randomized post-test only without control group design was conducted at Sanglah Hospital-Blood Bank, Bali. The consecutive random sampling technique was used in this study to the PRC, who met the inclusion criteria. Samples of the SDF-1 group (N=84) were divided into 3 such as Group 1 (1-7 days), Group 2 (8-14 days), and Group 3 (15-21 days). However, 53 PRC was divided into 2 groups as Group 1 (1-7 days) and Group 2 (8-14 days). The SDF-1 and TGF-?1 levels were evaluated for each group using Human SDF-1/CXCL12 and TGF-?1 Kit from Elabcience® by ELISA method. Data were analyzed using SPSS version 25 for Windows software.
Results: The median levels of SDF-1 in Group 1 group was 0.385 (0.050-1.020) ng/mL, followed by 0.455 (0.330-0.750) ng/ml in Group 2, and 0.490 (0.380-0.920) ng/ml in Group 3 (p<0.05). The mean of TGF-?1 levels was slightly higher in Group 1 (2,365.21±715.96 pg/ml) compared with Group 2 (2,210.39±994.68 pg/ml) (p=0.523). There was a significant difference in SDF-1 levels in Group 1-Group 2 (P=0.041) and Group 1-Group 3 (P=0.000) groups; however, no significant difference was found in Group 2-Group 3 (P=0.133) using the Mann-Whitney test. The Spearman's rho test found a moderate positive correlation between SDF-1 levels and storage time by day (r=0.546; P=0.000). In addition, based on the Pearson correlation test, there was a weak positive correlation between TGF-?1 levels and storage time by day (r=0.461; p=0.001).
Conclusion: The increase of SDF-1 and TGF-?1 levels in PRC by days of storage time could be used as the indicator for storage lesion at Sanglah General Hospital-Blood Bank, Bali, Indonesia.