Time Trial Performance Is Sensitive to Low-Volume Autologous Blood Transfusion

Abstract

Purpose This study tested the hypothesis that autologous blood transfusion (ABT) of ~50% of the red blood cells (RBC) from a standard 450-mL phlebotomy would increase mean power in a cycling time trial. In addition, the study investigated whether further ABT of RBC obtained from another 450-mL phlebotomy would increase repeated cycling sprint ability. Methods In a randomized, double-blind, placebo-controlled crossover design (3-month wash-out), nine highly trained male subjects donated two 450-mL blood bags each (BT trial) or were sham phlebotomized (PLA trial). Four weeks later, a 650-kcal time trial (n = 7) was performed 3 d before and 2 h after receiving either ~50% (135 mL) of the RBC or a sham transfusion. On the following day, transfusion of RBC (235 mL) from the second donation or sham transfusion was completed. A 4 × 30-s all-out cycling sprint interspersed by 4 min of recovery was performed 6 d before and 3 d after the second ABT (n = 9). Results The mean power was increased in time trials from before to after transfusion (P < 0.05) in BT (213 ± 35 vs 223 ± 38 W; mean ± SD) but not in PLA (223 ± 42 vs 224 ± 46 W). In contrast, the mean power output across the four 30-s sprint bouts remained similar in BT (639 ± 35 vs 644 ± 26 W) and PLA (638 ± 43 vs 639 ± 25 W). Conclusions ABT of only ~135 mL of RBC is sufficient to increase mean power in a 650-kcal cycling time trial by ~5% in highly trained men. In contrast, a combined high-volume transfusion of ~135 and ~235 mL of RBC does not alter 4 × 30-s all-out cycling performance interspersed with 4 min of recovery.

Autologous Blood Transfusion Enhances Exercise Performance—Strength of the Evidence and Physiological Mechanisms

“…When applying a double-blind, placebo-controlled crossover design and 7–11 weeks cryopreservation, performance was enhanced by ~ 30% in a TTE lasting ~ 10 min [10] and by 3% in 5 mile and 10 km time trials (TT) [9, 14] in well-trained males receiving a reinfusion of RBCs reconstituted to normal haematocrit (Hct) from a ~ 900 mL donation. Generally, the high-quality ABT studies report enhanced performance by ~ 3–5% compared with pre-reinfusion performance in time trials lasting ~ 30–45 min [7, 9, 14] and that TTE is prolonged by ~ 30% in a test lasting ~ 10 min [10]. It is of note that all the best controlled studies investigated well-trained male athletes (Table 1).…”

“…To our knowledge, we recently completed the first study on the effect of a low-volume ABT using a randomized, double-blind, placebo-controlled crossover design. We demonstrated that reinfusion with ~ 135 mL of cold-stored RBCs, corresponding to ~ 225 mL of whole blood, is sufficient to increase mean power by ~ 5% and reduce elapsed time by ~ 4% in a 650 kcal cycling TT [7]. Concomitantly, haemoglobin concentration ([Hb]), Hct, and RBC count increased by 3% compared to their levels 3 days before reinfusion.…”

Annual banned‐substance review – Analytical approaches in human sports drug testing

“…Various strategies exist to artificially increase an athlete's red blood cell mass, several of which are prohibited in sports and, consequently, are commonly referred to as blood doping. Especially the enhanced arterial oxygen concentration resulting from an increased number of erythrocytes was identified as a key factor positively affecting endurance performance, and also chronically altitude‐adapted endurance athletes were reported to respond to drug‐induced erythropoiesis with an enhanced hematocrit, hemoglobin concentration, reticulocyte percentage, and improved time trial performances …”

Association Between Implementation of the Athlete Biological Passport and Female Elite Runners’ Performance

“…Also, very few studies have investigated the effects of low-volume blood transfusions on athletic performance, and these results are controversial. 24,25 The considerable amount of doping cases (Table 2) coinciding with implementation of the ABP provides grounds to speculate that the magnitude of the performance decrease reflects the gains that were available by means of blood doping before. Such performance increases would require transfusion of >800 mL of whole blood or the use of erythropoiesis-stimulating substances in significant dosages, both of which are reliably detectable by the ABP nowadays.…”