Transfusion · 2025
Generation of enzyme-converted type O whole blood from type A whole blood: A translational study using swine whole blood.
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Nowadly Craig D, Casleton Brian G, Caballero Manuel Y, Xia Hui, Ediger David S, Moon Haisle, Ip Isis, Macdonald Spencer S, Jones Karolina, Rahfeld Peter, Kizhakkedathu Jayachandran N, Withers Stephen G, Rall Jason M
Аннотация
BACKGROUND: Low-titer O whole blood (LTOWB) is increasingly used to improve trauma outcomes, but maintaining supplies remains challenging, particularly in austere environments. This study evaluated EnzAO1 (FpGalNAcDeAc) and EnzAO2 (FpGalNase) to generate enzyme-converted O type whole blood (ECO-WB) from A type swine whole blood (WB).
STUDY DESIGN AND METHODS: WB from 16 A type and 4 O type swine were collected in Citrate Phosphate Dextrose Adenine-1 (CPDA-1). Type A WB was randomized to enzymatic conversion at either room temperature or 4°C. Each unit was divided into 45 mL aliquots and treated with no enzyme or one of four enzyme concentrations (1.75-17.5 μg/mL). Samples were analyzed at 15, 30, 60, and 120 min. A-antigen reduction was measured by flow cytometry. Blood counts, blood gases, rotational thromboelastometry, osmotic fragility, and free hemoglobin were used to assess blood post-conversion.
RESULTS: Enzymatic treatment converted A type swine WB to ECO-WB in a concentration- and time-dependent manner. At the highest enzyme concentration (17.5 μg/mL), A antigen expression was reduced to 0.6% ± 0.2% by 15 min, comparable to the signal observed in type O controls (0.45% ± 0.45%). No significant differences in antigen conversion were observed between temperature conditions. ECO-WB demonstrated stable hematologic profiles compared to controls.
DISCUSSION: This study demonstrates enzymatic conversion of type A swine WB into ECO-WB, reducing A antigen expression comparable to type O WB without compromising blood quality. The process is compatible with refrigerated and room temperature storage, supporting its application in diverse clinical and operational settings.
STUDY DESIGN AND METHODS: WB from 16 A type and 4 O type swine were collected in Citrate Phosphate Dextrose Adenine-1 (CPDA-1). Type A WB was randomized to enzymatic conversion at either room temperature or 4°C. Each unit was divided into 45 mL aliquots and treated with no enzyme or one of four enzyme concentrations (1.75-17.5 μg/mL). Samples were analyzed at 15, 30, 60, and 120 min. A-antigen reduction was measured by flow cytometry. Blood counts, blood gases, rotational thromboelastometry, osmotic fragility, and free hemoglobin were used to assess blood post-conversion.
RESULTS: Enzymatic treatment converted A type swine WB to ECO-WB in a concentration- and time-dependent manner. At the highest enzyme concentration (17.5 μg/mL), A antigen expression was reduced to 0.6% ± 0.2% by 15 min, comparable to the signal observed in type O controls (0.45% ± 0.45%). No significant differences in antigen conversion were observed between temperature conditions. ECO-WB demonstrated stable hematologic profiles compared to controls.
DISCUSSION: This study demonstrates enzymatic conversion of type A swine WB into ECO-WB, reducing A antigen expression comparable to type O WB without compromising blood quality. The process is compatible with refrigerated and room temperature storage, supporting its application in diverse clinical and operational settings.