de Vroege R, Wildevuur W R, Muradin J A G, Graves D, van Oeveren W
Department of Extracorporeal Circulation, Free University Medical Center, 1007 MB Amsterdam, The Netherlands.
Vox Sang. 2007 Feb;92(2):130-5. doi: 10.1111/j.1423-0410.2006.00852.x.
The use of an autotransfusion device to wash blood of the incision site is increasing. After washing, this blood is retransfused without side effects caused by activated plasma factors and cell release products. This procedure could be extended to washing of donor blood, which may be particularly useful for red blood cells (RBCs) stored for more than 4 weeks that contain high concentrations of free haemoglobin, potassium, lactate and other metabolites. It is not known whether stored RBCs can withstand the cell washing procedure with the use of an autotransfusion device, while keeping their primary functions intact. The objective of this study was to determine the quality of RBCs, after cell washing in comparison to untreated RBCs.
RBCs were studied in terms of integrity (free haemoglobin), stored energy (2,3-diphosphoglycerate, adenosine triphosphate), metabolites (lactate, potassium) and physical characteristics (osmotic resistance, aggregability, deformability).
After washing, free lactate and potassium were significantly reduced as compared to the levels before washing. The osmotic resistance of RBCs slightly improved, whereas aggregation capacity reduced after washing. Fifteen per cent of haemoglobin was lost during washing. The deformability and free haemoglobin levels remained unchanged.
Washing stored blood before transfusion may be of benefit, because the waste products are effectively removed from the stored RBC.
使用自动输血装置清洗手术切口部位血液的情况日益增多。清洗后的血液回输时不会产生由活化血浆因子和细胞释放产物引起的副作用。该程序可扩展至对供血进行清洗，这对于储存超过4周、含有高浓度游离血红蛋白、钾、乳酸及其他代谢产物的红细胞可能特别有用。目前尚不清楚储存的红细胞在使用自动输血装置进行细胞清洗过程中，其主要功能是否能保持完整。本研究的目的是比较经细胞清洗后的红细胞与未处理的红细胞的质量。
从完整性（游离血红蛋白）、储存能量（2,3 - 二磷酸甘油酸、三磷酸腺苷）、代谢产物（乳酸、钾）和物理特性（渗透压耐受性、聚集性、变形性）方面对红细胞进行研究。
清洗后，游离乳酸和钾的含量与清洗前相比显著降低。红细胞的渗透压耐受性略有提高，而聚集能力在清洗后降低。清洗过程中有15% 的血红蛋白损失。变形性和游离血红蛋白水平保持不变。
输血前清洗储存血液可能有益，因为能有效去除储存红细胞中的代谢废物。
