277 - Potential Concern with Blood Transfusion

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 277
Publication Number: 277.131

Raja R. Nandyal, Oklahoma University Health Sciences Center, EDMOND, OK, United States; Doaa Atwi, Oklahoma Childrens Hospital at OU Health, Nichols Hills, OK, United States; Jeffrey Eckert, Oklahoma Childrens Hospital at OU Health, Oklahoma City, OK, United States; Jolyn Fernandes, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States; Abhishek Makkar, Oklahoma Childrens Hospital at OU Health, Oklahoma City, OK, United States

Presenting Author(s)

RN

Raja R. Nandyal, MD (he/him/his)

Professor of Pediatrics- Neonatology
Oklahoma University Health Sciences Center
EDMOND, Oklahoma, United States

Background: Half of extremely low birth weight infants receive at least 1 transfusion during their first two weeks. Their distinctive problems such as intraventricular hemorrhage, bronchopulmonary dysplasia etc, contribute to their morbidity and mortality. No US recommendations exist for routine screening of the donated blood and blood products, for heavy metals, and nicotine products. Addressing this knowledge gap and their contributing role in our patients’ morbidity and mortality, our multidisciplinary team designed this observational study with following hypothesis and specific aims.

Objective: 1. To assess for the presence of 24 heavy metals and nicotine bi-products (Qualitative) in our donors’ blood. 2: To measure each of the tested metals and nicotine bi-products (quantitative), and compare (variance) with US EPA approved levels.

Design/Methods: Blood collected and processed as per Blood Institute recs. Two to 3 segments collected from each unit and contents of segments transferred to a BD Vacutainer® SPC Plus plastic tube for Trace Element Testing (BD, Franklin Lakes, NJ) using a SEG-SAFE™ Segment processor (Alpha Scientific Corp, Exton, PA). Samples stored at -20 degrees centigrade until processed for heavy metals. Quantification of 24 metals in blood samples by Inductively Coupled Plasma Mass Spectrometry- Briefly 100uL blood samples with internal standards, subjected to wet acid digestion at high temperature using nitric acid and hydrogen peroxide. Each sample diluted and ran as technical replicates using Thermo Scientific™ iCAP™ TQe ICP-MS, in collision cell mode using kinetic energy dissociation. For each metal a linear curve was established ranging from 0-64ppb. One Red Blood cell segment used to quantify cotinine levels by ELISA (CalBioTech, El Cajon CA) according to the manufacturer.

Results: All 160 blood samples analyzed. Eleven percent of the BRC segments positive for cotinine at levels greater then 10ng/ml, consistent with current smoking. Preliminary studies on human blood samples showed presence of potentially toxic heavy metals such as cadmium (0.56), uranium (5.19), tungsten (2.19), tin (12.41), platinum (7.45), in addition to nutritionally relevant metals such as copper, zinc, manganese, selenium and copper. Sources for toxic heavy metal presence in human blood could be from smoking, anthropogenic activities or environmental exposures.

Conclusion(s): The percent of cotinine positive RBC segments is consistent with the reported. Preliminaries on human blood samples showed presence of potentially toxic heavy metals. Future studies might steer us towards their clinical implications.