Advances in techniques for red blood cell storage have made feasible the prolonged liquid storage of red blood cell concentrates for 42 days, which allows red blood cells to be readily available for transfusion to anemic patients. For example, even surgical procedures associated with very large, acute blood losses can now be performed given the ready availability of red blood cells for transfusion. To maintain adequate tissue oxygenation during acute blood loss. 1) lost blood volume must be adequately replaced by crystalloid or colloid solutions to maintain tissue perfusion, and 2) lost red blood cells must be adequately replaced by red blood cell transfusion to maintain adequate oxygen-carrying capacity. This proposal is directed toward the later of these two requirements. Red blood cells are transfused to prevent or treat inadequate tissue oxygenation. Currently, tissue oxygenation is not directly measured, and as a result, transfusion of red blood cells are based on vague clinical criteria, especially when the hemoglobin, concentrations is between 7 and 10 g/dL. It is the objective of this proposal to directly measure tissue oxygen in humans during acute normovolemic anemia and red blood cell transfusion. To accomplish this objective, we will study tissue oxygen in accessible tissues (whole-body and local oxygenation) in 196 human subjects. Three groups of subjects will be studied; 1) healthy subjects who undergo acute normovolemic hemodilution, in whom whole-body and subcutaneous oxygenation will be simultaneously measured, 2) posterior spine fusion patients, who develop acute normovolemic anemia due to surgical blood loss, in whom subcutaneous oxygenation will be measured, and 3) major hepatectomy patients who develop acute normovolemic anemia due to surgical blood loss, in whom subcutaneous, gastrointestinal serosal surface and gastric mucosal oxygenation will be measured. In addition, subcutaneous tissue oxygen will be measured immediately and 24 hours after red blood cell transfusion. Data from this proposal will provide information as to whether and how tissue oxygen decreases in acute normovolemic anemia in humans, and whether and when tissue oxygen increases with red blood cell transfusion. This research is directly responsive to the RFA-s area of emphasis: """"""""Indications for red blood cell transfusion.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Specialized Center (P50)
Project #
Application #
Study Section
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of California San Francisco
San Francisco
United States
Zip Code
Kamata, Tamihiro; Dankort, David; Kang, Jing et al. (2013) Hematopoietic expression of oncogenic BRAF promotes aberrant growth of monocyte-lineage cells resistant to PLX4720. Mol Cancer Res 11:1530-41
Weiskopf, Richard B; Feiner, John; Toy, Pearl et al. (2012) Fresh and stored red blood cell transfusion equivalently induce subclinical pulmonary gas exchange deficit in normal humans. Anesth Analg 114:511-9
Feiner, John R; Finlay-Morreale, Heather E; Toy, Pearl et al. (2011) High oxygen partial pressure decreases anemia-induced heart rate increase equivalent to transfusion. Anesthesiology 115:492-8
Bloch, Evan M; Reed, William F; Lee, Tzong-Hae et al. (2011) Male microchimerism in peripheral blood leukocytes from women with multiple sclerosis. Chimerism 2:6-10
Weiskopf, Richard B (2010) Conflicts of interest in expert-authored practice parameters, standards, guidelines, recommendations. Anesthesiology 113:751-2; author reply 752-3
Gill, Ryan M; Lee, Tzong-Hae; Utter, Garth H et al. (2008) The TNF (-308A) polymorphism is associated with microchimerism in transfused trauma patients. Blood 111:3880-3
Finlay-Morreale, Heather E; Louie, Clifton; Toy, Pearl (2008) Computer-generated automatic alerts of respiratory distress after blood transfusion. J Am Med Inform Assoc 15:383-5
Reed, William; Lee, Tzong-Hae; Norris, Philip J et al. (2007) Transfusion-associated microchimerism: a new complication of blood transfusions in severely injured patients. Semin Hematol 44:24-31
Nicholas, Cory R; Gaur, Meenakshi; Wang, Shaohui et al. (2007) A method for single-cell sorting and expansion of genetically modified human embryonic stem cells. Stem Cells Dev 16:109-17
Lee, Tzong-Hae; Chafets, Daniel M; Reed, William et al. (2006) Enhanced ascertainment of microchimerism with real-time quantitative polymerase chain reaction amplification of insertion-deletion polymorphisms. Transfusion 46:1870-8

Showing the most recent 10 out of 74 publications