Blood storage alters mechanical stress responses of erythrocytes

Abstract

BACKGROUND: Erythrocytes undergo irreversible morphological and biochemical changes during storage. Reduced levels of deformability have been reported for stored erythrocytes. Erythrocyte deformability is essential for healthy microcirculation.OBJECTIVE: The aim of this study is to evaluate shear stress (SS) induced improvements of erythrocyte deformability in stored blood.METHODS: Deformability changes were evaluated by applying physiological levels of SS (5 and 10 Pa) in metabolically depleted blood for 48 hours and stored blood for 35 days with citrate phosphate dextrose adenine-1 (CPDA-1). Laser diffractometry was used to measure erythrocyte deformability before and after application of SS.RESULTS: Erythrocyte deformability, as a response to continuous SS, was significantly improved in metabolically depleted blood, whereas it was significantly impaired in the blood stored for 35 days with CPDA-1 (p≤0.05). The SS-induced improvements of deformability were deteriorated due to storage and relatively impaired according to the storage time. However, deformability of stored blood after exposure to mechanical stress tends to increase at low levels of shear while decreasing at high SS levels.CONCLUSION: Impairment of erythrocyte deformability after storage may contribute to impairments in the recipient’s microcirculation after blood transfusion. The period of the storage should be considered to prevent microcirculatory problems and insufficient oxygen delivery to the tissues.

Development of a flow standard to enable highly reproducible measurements of deformability of stored red blood cells in a microfluidic device

“…Our results suggest that changes unfold in two phases bridged by a 2‐week plateau (between Days 7 and 21) when changes in RBC deformability are not statistically significant. Previous reports of deformability impairment occurring before Day 7 or after Day 21 are partly in line with our observations . Bennett‐Guerrero et al concluded that RBC deformability measured using ektacytometry was gradually altered over the 42‐day storage period.…”

“…RBC deformability impairment has previously been reported as part of storage lesions, while the moment of occurrence is still a matter of debate . Our results suggest that changes unfold in two phases bridged by a 2‐week plateau (between Days 7 and 21) when changes in RBC deformability are not statistically significant.…”

Donor‐dependent aging of young and old red blood cell subpopulations: Metabolic and functional heterogeneity

“…These progressive morphologic and metabolic changes in RBCs after processing (washing alone or Percoll separation) and throughout storage were accompanied by changes in RBC quality characteristics including increased hemolysis and decreased Hb‐p50 and deformability, which is consistent with previously reported results 34,62–64 . The significantly increased hemolysis and rigidity and decreased elongation in the group of washed but unseparated RCCs show the high sensitivity of RBCs to the secondary effect of washing and storage methods on processed RBCs.…”

“…57,58 These progressive morphologic and metabolic changes in RBCs after processing (washing alone or Percoll separation) and throughout storage were accompanied by changes in RBC quality characteristics including increased hemolysis and decreased Hb-p50 and deformability, which is consistent with previously reported results. 34,[62][63][64] of senescent RBCs within a RCC will presumptively have higher accumulation of side products of aging/lysis that undoubtedly affect the quality of the whole RCC unit. Other studies have discussed the impact of donor age and sex on both the quality characteristics of RCCs during in vitro storage 22,25,28,65 and the transfusion efficacy, [66][67][68][69] with an increased risk of mortality due to sex-mismatched transfusions.…”

Technology Advancements in Blood Coagulation Measurements for Point-of-Care Diagnostic Testing

“…Blood coagulation and fibrinolysis are complex processes in which platelets, fibrins, enzymes, and a series of complex chemical reactions play a role. Since red blood cells (RBCs) also have significant functions in blood clotting and its disorders (Demiroglu, 1997;Yalcin et al, 2016;Litvinov and Weisel, 2017), the RBC rheology in different disease conditions has been widely studied (Ertan et al, 2017;Ugurel et al, 2017;Yalcin et al, 2017). For example, red blood deformability is controlled by calcium (Yalcin et al, 2016) and it directly affects the blood viscosity and clotting.…”