Weisbach V, Riego W, Strasser E, Zingsem J, Ringwald J, Zimmermann R, Eckstein R
Department of Transfusion Medicine and Haemostaseology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Vox Sang. 2004 Jul;87(1):19-26. doi: 10.1111/j.1423-0410.2004.00526.x.
No data are currently available on the quality of washed prestorage leucocyte-depleted red blood cell concentrates (RCCs).
Five groups of RCCs stored in additive solution (SAG-M) were washed. The groups differed in the age of RCCs (2-5 days or 11-15 days), the temperature during the washing procedure and a 6-h storage period (4 degrees C or room temperature) and the washing solution (saline, SAG-M or 5% albumin). We measured ATP, 2,3-diphosphoglycerate (2,3-DPG), haemolysis, blood cell count, Na(+), K(+), pH, pO(2), pCO(2) and lactate, before and after the washing procedure and hourly during the 6-h postwash storage period.
The erythrocyte ATP content increased by 2-13%, relative to the baseline value, during the washing procedure. The 2,3-DPG level decreased by 15-35% in 2-6-day-old RCCs and by 30-40% in 11-15-day-old RCCs (relative to baseline values) during the washing procedure. In RCCs that were washed and stored at room temperature, and in 2-week-old RCCs, a further decrease in 2,3-DPG of up to 40%, relative to the baseline value, was observed during the 6-h postwash time-period.
Washing of RCCs stored in SAG-M results in a considerable, significant loss of erythrocyte 2,3-DPG, especially in older RCCs. This loss increases in during a 6-h storage period postwash, even at 4 degrees C. This loss of erythrocyte quality might well outweigh the benefits of washed SAG-M RCCs during massive transfusion in neonates.
目前尚无关于洗涤后储存前白细胞滤除红细胞浓缩液(RCCs)质量的数据。
对五组储存于添加剂溶液(SAG-M)中的RCCs进行洗涤。这些组在RCCs的保存时间(2 - 5天或11 - 15天)、洗涤过程中的温度以及6小时储存期(4℃或室温)和洗涤溶液(生理盐水、SAG-M或5%白蛋白)方面存在差异。我们在洗涤前后以及洗涤后6小时储存期内每小时测量ATP、2,3 - 二磷酸甘油酸(2,3 - DPG)、溶血、血细胞计数、Na⁺、K⁺、pH、pO₂、pCO₂和乳酸。
在洗涤过程中,红细胞ATP含量相对于基线值增加了2% - 13%。在洗涤过程中,2 - 6天龄的RCCs中2,3 - DPG水平下降了15% - 35%,11 - 15天龄的RCCs中下降了30% - 40%(相对于基线值)。在室温下洗涤并储存的RCCs以及2周龄的RCCs中,在洗涤后6小时期间观察到2,3 - DPG相对于基线值进一步下降高达40%。
洗涤储存于SAG-M中的RCCs会导致红细胞2,3 - DPG大量显著损失,尤其是在较老的RCCs中。这种损失在洗涤后6小时储存期内会增加,即使在4℃时也是如此。在新生儿大量输血期间,这种红细胞质量的损失可能远超过洗涤后的SAG-M RCCs所带来的益处。