Levels of tissue inhibitor of metalloproteinases-1 in blood transfusion components

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Abstract
Blood transfusion during surgery for solid tumors may reduce patient survival because of various bioactive substances present in blood preparations. The antiproteolytic protein tissue inhibitor of metalloproteinases-1 (TIMP-1) present in large quantities in platelets has been shown to stimulate cell growth and to inhibit apoptosis and may therefore be considered to influence tumor progression. We measured TIMP-1 levels in blood transfusion preparations, especially in plateletcontaining preparations, before and after leucofiltration and at different timepoints during storage. The mean TIMP-1 levels in whole blood (WB) and plateletrich plasma (PRP) were slightly reduced by leucofiltration; WB: 41.6 mug/L versus 34.9 mug/L, PRP: 139.8 mug/L versus 127.2 mug/L. However, with prestorage leucofiltration, TIMP-1 levels in buffy-coat-derived platelet (BCP) pools were significantly reduced from 134.2 mug/L to 102.2 mug/L (p=0.0013). In saline-adenineglucose-mannitol (SAG-M) blood preparations in which the platelet content is reduced by more than 99%, TIMP-1 could not be detected. Extracellular TIMP-1 accumulated significantly in non-filtered WB and in aferesis platelet concentrates (APC), but TIMP-1 was at no time detectable in SAG-M blood during storage. In conclusion, TIMP-1 is present in various platelet-containing blood preparations, but not in platelet-free preparations such as SAG-M, indicating that most of the TIMP-1 measured in blood preparations originates from platelets. Furthermore, TIMP-1 levels increased during storage in preparations containing platelets, which suggests a continuous disintegration of platelets. These data imply that information on preoperative blood transfusions should be taken into account when evaluating plasma TIMP-1 levels in patients.

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