Evolution of adverse changes in stored RBCs
| Autor: | Robert M. Califf, Elliott Bennett-Guerrero, Allan Doctor, Hongmei Zhu, Thomas L. Ortel, Melissa A. Mulherin, Marilyn J. Telen, Timothy J. McMahon, Raymond Buck, Tim Veldman, T. Scott Reid |
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| Rok vydání: | 2007 |
| Předmět: |
Erythrocytes
Time Factors Blood transfusion medicine.medical_treatment Vasodilation Phosphatidylserines Nitric oxide Andrology Hemoglobins chemistry.chemical_compound In vivo Mole medicine Humans Lactic Acid Cell Shape 2 3-Diphosphoglycerate S-Nitrosothiols Multidisciplinary Blood flow Hydrogen-Ion Concentration Biological Sciences Cell Hypoxia Lactic acid Oxygen chemistry Blood Preservation Immunology Potassium Commentary Hemoglobin Shear Strength |
| Zdroj: | Proceedings of the National Academy of Sciences. 104:17063-17068 |
| ISSN: | 1091-6490 0027-8424 |
| Popis: | Recent studies have underscored questions about the balance of risk and benefit of RBC transfusion. A better understanding of the nature and timing of molecular and functional changes in stored RBCs may provide strategies to improve the balance of benefit and risk of RBC transfusion. We analyzed changes occurring during RBC storage focusing on RBC deformability, RBC-dependent vasoregulatory function, and S -nitrosohemoglobin (SNO-Hb), through which hemoglobin (Hb) O 2 desaturation is coupled to regional increases in blood flow in vivo (hypoxic vasodilation). Five hundred ml of blood from each of 15 healthy volunteers was processed into leukofiltered, additive solution 3-exposed RBCs and stored at 1–6°C according to AABB standards. Blood was subjected to 26 assays at 0, 3, 8, 24 and 96 h, and at 1, 2, 3, 4, and 6 weeks. RBC SNO-Hb decreased rapidly (1.2 × 10 −4 at 3 h vs. 6.5 × 10 −4 (fresh) mol S -nitrosothiol (SNO)/mol Hb tetramer ( P = 0.032, mercuric-displaced photolysis-chemiluminescence assay), and remained low over the 42-day period. The decline was corroborated by using the carbon monoxide-saturated copper-cysteine assay [3.0 × 10 −5 at 3 h vs. 9.0 × 10 −5 (fresh) mol SNO/mol Hb]. In parallel, vasodilation by stored RBCs was significantly depressed. RBC deformability assayed at a physiological shear stress decreased gradually over the 42-day period ( P < 0.001). Time courses vary for several storage-induced defects that might account for recent observations linking blood transfusion with adverse outcomes. Of clinical concern is that SNO levels, and their physiological correlate, RBC-dependent vasodilation, become depressed soon after collection, suggesting that even “fresh” blood may have developed adverse biological characteristics. |
| Databáze: | OpenAIRE |
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