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.