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  • Evaluation of mitochondrial DNA level among different blood products
  • Fatemeh Hajiabadi,1 Saeede Bagheri,2 Mohammad Hossein Ahmadi,3,*
    1. Department of Laboratory Sciences, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
    2. Department of Laboratory Sciences, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
    3. Department of Laboratory Sciences, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.


  • Introduction: DNA found in the extracellular environment, regardless of its structure, is called extracellular DNA (ecDNA). The ecDNA consists mainly of nuclear DNA (nucDNA) and mitochondrial DNA (mtDNA). EcDNA can be found in the extracellular milieu of blood products. MtDNA has a similar structure to bacterial DNA due to its proteobacterial origin. They are known as damage associated molecular patterns (DAMPs) that contribute to inflammation. The mtDNA modulates immune cells and may cause adverse transfusion reactions. It has been demonstrated that extracellular mtDNA can contribute to adverse transfusion reactions such as nonhemolytic transfusion reactions (NHTRs), transfusion-related acute lung injury (TRALI), and acute respiratory distress syndrome (ADSR) and febrile nonhemolytic transfusion reaction (FNHTR). Stored blood products can contain variable amounts of mtDNA pro-inflammatory fragments. Many questions about the amount of mtDNA in different blood products have been established. Based on this, our purpose in this review was to compare the amount of mtDNA in different blood products including types of RBC units (RBCU), fresh frozen plasma (FFP) and platelet concentration (PC).
  • Methods: The result of our review is based on the analysis of articles published between 2010 and 2022. In PubMed, Google Scholar, and Scopus databases, we found relevant articles by searching keywords such as mtDNA DAMPs, blood products, mitochondrial DNA, mtDNA AND adverse transfusion reactions.
  • Results: Results showed that mtDNA levels are different among blood products. A higher level of mtDNA in FFP and PCs than in RBCU has been showed. However, the result of comparison of mtDNA levels between FFP and PCs varied in different investigations regarding various measurement methods. A higher level of mtDNA was present in whole blood filtration units than in red cell filtration units. Moreover, among the different platelet products based on the preparation method, platelet-rich plasma (PRP) had a significantly higher mtDNA level than buffy coat (BC) and apheresis units.
  • Conclusion: Based on the obtained results, FFP and PCs had the highest amount of mtDNA compared to RBCU. The high levels of mtDNA in FFPs could be due to the occurrence of leukocyte rupture during the thawing process before transfusion. In addition, a high amount of mtDNA in PCs could be due to oxidative mtDNA damage and subsequent development of mtDNA DAMPs. As these products contain a higher amount of mtDNA, they are more likely to cause adverse transfusion reactions associated with mtDNA. Given that, further research should focus on minimizing the level of mtDNA in blood products, specifically PCs and FFP.
  • Keywords: Mitochondrial DNA, DAMPs, Damage associated molecular pattern, mtDNA, Blood products