Rheological properties and function of blood cells in stored bank blood and salvaged blood

Background: More than 5 million patients receive erythrocyte transfusions in the United States every year. Previous studies linked the storage duration of allogeneic erythrocytes to the risk of severe postoperative complications, especially after cardiac or trauma surgery. Limited data are available for noncardiac surgical patients. We therefore evaluated the association between storage duration of transfused erythrocytes and postoperative all-cause mortality among general surgery patients. Methods: Perioperative data corresponding to 63,319 adult, general surgery patients were obtained from our registry and merged with blood product data. Patients receiving solely leukocyte-reduced, allogeneic erythrocyte transfusions were included. Multivariable Cox proportional hazards regression was used to characterize the relationship between median erythrocyte storage duration and postoperative mortality rate, adjusting for characteristics plausibly influencing the storage duration of erythrocytes. Results: Of the 6,994 patients included in the final analysis, 23, 44, 11, 9, and 13% received 1, 2, 3, 4, and ≥5 erythrocyte units, respectively. The authors found no evidence that increasing median storage duration was associated with a difference in the risk of postoperative mortality (hazard ratio, 0.99 [0.94-1.04]; P = 0.64). Analyzing the mean storage duration of erythrocyte units as a function of year of transfusion, the authors demonstrate a relevant decrease in utilization of the oldest blood units, whereas young blood storage duration remains nearly unchanged. Conclusion:The authors' study supports the recent literature in surgical and medical patients and underlines the importance of sufficiently powered randomized trials to finally resolve the erythrocyte storage duration debate.

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“…12,[15][16][17] However, the effect of these observed changes on clinical outcomes of transfused patients remains unclear.…”

Section: Storage Duration Of Blood and Mortalitymentioning

confidence: 99%

Erythrocyte Storage Duration Is Not Associated with Increased Mortality in Noncardiac Surgical Patients

Saager

Turan

Dalton³

et al. 2013

Anesthesiology

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“…During storage, RBC membranes become markedly altered [14], and echinocytic shape transformation with microvesicles budding from the tips of echinocytic spicules have been observed [15, 16]. Impaired rheologic properties of stored whole blood have been reported [17, 18, 19]. …”

Section: Introductionmentioning

confidence: 99%

Effects of Leucocyte Depletion on Rheologic Properties of Human CPDA-1 Blood

et al. 2000

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Background and Objectives: Leucocyte depletion improves the quality of stored blood units. We have studied its role on blood viscosity. Materials and Methods: Viscosity of CPDA-1 blood units was measured in a Couette viscometer at shear rates of 94.5 and 0.1 s^–1 prior to and following filtration with the Leukotrap^® A1 system on day 0 and after 21 days at +4°C. Results: On day 0, high but not low shear viscosity was significantly decreased. The red blood cell morphology was unaffected. On day 21, blood viscosity was increased similarly for unfiltered and filtered samples at both shear rates. The echinocytosis observed after storage correlated with the increase in viscosity. Conclusion: Leucocyte depletion is associated with a decrease in high shear viscosity. This effect is, however, completely lost after 21 days.

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“…Statistical deviations in filterability, as quantified by the variances in the observed β factor, were observed after 4 weeks of storage [22]. Furthermore, all biochemical properties of blood were found to statistically significant at all storage times after 1 week [23].…”

Section: Discussionmentioning

confidence: 99%

Blood Quality Diagnostic Device Detects Storage Differences Between Donors

Jani

Mailo

Athar

et al. 2017

IEEE Trans. Biomed. Circuits Syst.

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In 2013, nearly 15 million units of banked blood were transfused in the United States alone. Blood shortages are expected to increase globally. Donated blood is not equal due to differences in quality and deterioration rate. There are no methods to detect time-dependent biochemical and biophysical changes of RBCs or the deterioration rate of donated RBCs. Nine randomly selected RBC units collected by the San Diego Blood Bank were examined for inter-donor variability over six weeks of storage. In vitro RBC quality was assessed weekly by conventional biochemical tests including free Hb, K+, ATP, P50, 2,3 DPG, lactate, and pH. Deformability was measured via cell filtration. Briefly, the RBC suspension (10% Hct), was forced through a 5.0μm pore membrane (106 mm2) at various flow rates. No inter-donor variability in biochemical or mechanical parameters was observed at baseline. Inter-donor variability in biochemical properties (free Hb, K+, ATP, P50, 2,3 DPG, lactate, and pH) was observed after 14 days of storage. However, significant differences from baseline in RBC mechanical properties (i.e. filterability) were observed as early as 7 days into storage at the lowest flow rates and after 28 days of storage at all flow rates. There was a net decrease in filterability over time for all donors, but the rate at which filterability decreased (i.e. deterioration rates) was different when comparing individual donors. Changes in all biochemical parameters were significant different between donors. These data suggest that filterability is more sensitive to changes in blood quality than conventional biochemical parameters.

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Rheological properties and function of blood cells in stored bank blood and salvaged blood

Cited by 51 publications

References 22 publications

Erythrocyte Storage Duration Is Not Associated with Increased Mortality in Noncardiac Surgical Patients

Erythrocyte Storage Duration Is Not Associated with Increased Mortality in Noncardiac Surgical Patients

Effects of Leucocyte Depletion on Rheologic Properties of Human CPDA-1 Blood

Blood Quality Diagnostic Device Detects Storage Differences Between Donors

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