Complement inhibition significantly decreases red blood cell lysis in a rat model of acute intravascular hemolysis

Transfusion. 2014 Nov;54(11):2892-900. doi: 10.1111/trf.12695. Epub 2014 May 8.


Background: Prevention of acute hemolytic transfusion reactions is a worldwide concern. The objective of this study was to develop a simple rat model of complement-mediated acute intravascular hemolysis.

Study design and methods: Human AB red blood cells (RBCs) were incubated with complement-sufficient or complement-deficient Wistar rat serum (WRS) in the presence and absence of human RBC antibody in vitro to elucidate the mechanism of hemolysis. To study the role of complement in acute intravascular hemolysis in vivo, Wistar rats were treated either with or without cobra venom factor (CVF) to deplete complement activity. Human AB RBCs were then injected into both groups of rats, followed by serial blood draws up to 2 hours. Venous blood clearance and lysis of transfused RBCs at each time point were measured by flow cytometry and spectrophotometry. RBC sequestration was determined in the liver, spleen, and kidney by immunohistochemistry.

Results: In vitro incubation of human RBCs with WRS demonstrated that RBC lysis was mediated via the classical complement pathway and that hemolysis was antibody dependent. Transfusion of human RBCs into rats showed significantly less hemolysis in the CVF group versus untreated group. RBC sequestration in the spleen and liver 2 hours posttransfusion were not quantitatively different between the two groups.

Conclusions: Given the much higher degree of similarity for rat and human complement compared to mice, this simple rat model is ideal for testing novel inhibitors of classical pathway activation for the prevention and treatment of acute intravascular hemolysis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Acute Disease
  • Animals
  • Complement Inactivating Agents / pharmacology
  • Complement Pathway, Classical / drug effects
  • Complement System Proteins*
  • Disease Models, Animal
  • Elapid Venoms / pharmacology
  • Erythrocyte Transfusion / adverse effects*
  • Erythrocytes / metabolism*
  • Erythrocytes / pathology
  • Hemolysis*
  • Humans
  • Liver / metabolism*
  • Liver / pathology
  • Mice
  • Rats
  • Rats, Wistar
  • Species Specificity
  • Spleen / metabolism*
  • Spleen / pathology


  • Complement Inactivating Agents
  • Elapid Venoms
  • cobra venom factor
  • Complement System Proteins