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PHTHALATES RELEASED AFTER ERYTHROCYTE SUSPENSION: DO THEY POSE A RISK?
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  • Edip Gonullu,
  • Sevdegul Bilvanisi,
  • Aydın Tasdogen ,
  • Hayriye Gonullu,
  • Yüksel Erkin,
  • Tuncay Kume,
  • Mehmet Coşkun Aykaç
Edip Gonullu
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Sevdegul Bilvanisi
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Aydın Tasdogen
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Hayriye Gonullu
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Yüksel Erkin
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Tuncay Kume
Dokuz Eylul University
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Mehmet Coşkun Aykaç
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Abstract

It is commonly known that stored blood and blood products are heated before transfusion in order to prevent hypothermia, which leads to increased di-(2-ethylhexyl) phthalate content leaching into the blood and blood products and thereby causes greater conversion of di-(2-ethylhexyl) phthalate to mono (2-ethylhexyl) phthalate. However, there has been no study in the literature reporting on the amount of toxic phthalates in blood following the erythrocyte suspension transfused via warming. In this study, we aimed to investigate the di-(2-ethylhexyl) phthalate and mono (2-ethylhexyl) phthalate content in blood following the ES transfusions administered by di-(2-ethylhexyl) phthalate -containing and di-(2-ethylhexyl) phthalate -free infusion sets. The study included 30 patients that were randomly divided into 2 groups with 15 patients each: group I underwent erythrocyte suspension transfusion via di-(2-ethylhexyl) phthalate -containing infusion sets warmed with blood-fluid warmers and group II underwent erythrocyte suspension transfusion via di-(2-ethylhexyl) phthalate-free infusion sets warmed with blood-fluid warmers. Di-(2-ethylhexyl) phthalate and mono (2-ethylhexyl) phthalate levels were measured both before and after transfusion. Di-(2-ethylhexyl) phthalate-free infusion sets led to no increase in the phthalate content, whereas di-(2-ethylhexyl) phthalate-containing infusion sets significantly increased the di-(2-ethylhexyl) phthalate and mono (2-ethylhexyl) phthalate levels, where the di-(2-ethylhexyl) phthalate level increased almost four times (p=0.001). Di-(2-ethylhexyl) phthalate-containing products lead to toxicity. Therefore, using di-(2-ethylhexyl) phthalate-free products may prevent toxicity in patients undergoing erythrocyte suspension transfusion.

Peer review status:UNDER REVIEW

11 Feb 2021Submitted to International Journal of Clinical Practice
12 Feb 2021Submission Checks Completed
12 Feb 2021Assigned to Editor
17 Feb 2021Reviewer(s) Assigned
29 Mar 2021Review(s) Completed, Editorial Evaluation Pending
26 Apr 20211st Revision Received
26 Apr 2021Assigned to Editor
26 Apr 2021Submission Checks Completed
01 May 2021Reviewer(s) Assigned
03 May 2021Review(s) Completed, Editorial Evaluation Pending
26 May 20212nd Revision Received
31 May 2021Assigned to Editor
31 May 2021Submission Checks Completed
31 May 2021Review(s) Completed, Editorial Evaluation Pending
05 Jun 2021Reviewer(s) Assigned