Bor-Kucukatay Melek, Keskin Ali, Akdam Hakan, Kabukcu-hacioglu Sibel, Erken Gülten, Atsak Piray, Kucukatay Vural
Pamukkale University, Faculty of Medicine, Department of Physiology, Kinikli, 20070 Denizli, Turkey.
Transfus Apher Sci. 2008 Oct;39(2):101-8. doi: 10.1016/j.transci.2008.07.004.
Platelet transfusions are increasingly being used to treat thrombocytopenic conditions. Because of anticoagulation, changes in blood composition and extracorporeal circulation, donor apheresis may cause alterations in hemorheology. This study aimed at investigating the effects of thrombocytapheresis on donor blood rheology. The effect of nitric oxide (NO) on donor red blood cell (RBC) deformability after thrombocytapheresis was also studied. Platelets were collected by a Haemonetics MCS 3p cell seperator. Blood samples were obtained before and 15 min after thrombocytapheresis. RBC deformability and aggregation were measured using an ektacytometer, whole blood viscosity (WBV) was determined with a cone-plate rotational viscometer. Donor RBCs were shown to be less deformable at all stress levels except 0.30 Pa after thrombocytapheresis and NO donor sodium nitroprusside (SNP, 10(-6) M) reversed the reduced deformability caused by thrombocytapheresis. It was observed that donor apheresis induces a decrement in RBC aggregation and WBV measured at standard hematocrit (Hct). No significant alterations were observed in WBV values determined at native Hct values. Thrombocytapheresis also resulted in a decrement in fibrinogen, total protein, cholesterol and albumin levels whereas Hct was found to be increased and serum glucose, triglyceride, hemoglobin levels unaltered after apheresis. These results suggest that, thrombocytapheresis causes alterations in hemorheological parameters and hence in the perfusion of the microvasculature of the donors and NO appears to have a protective effect on the impairment observed in RBC deformability.
血小板输注越来越多地用于治疗血小板减少症。由于抗凝、血液成分变化和体外循环,供体血液成分单采可能会导致血液流变学改变。本研究旨在调查血小板单采对供体血液流变学的影响。还研究了一氧化氮(NO)对血小板单采后供体红细胞(RBC)变形性的影响。通过Haemonetics MCS 3p细胞分离器采集血小板。在血小板单采前和单采后15分钟采集血样。使用红细胞变形仪测量RBC变形性和聚集性,用锥板旋转粘度计测定全血粘度(WBV)。结果显示,除了在0.30 Pa应力水平外,血小板单采后供体RBC在所有应力水平下的变形性均降低,而NO供体硝普钠(SNP,10(-6) M)可逆转血小板单采引起的变形性降低。观察到供体血液成分单采会导致在标准血细胞比容(Hct)下测量的RBC聚集性和WBV降低。在自然Hct值下测定的WBV值未观察到显著变化。血小板单采还导致纤维蛋白原、总蛋白、胆固醇和白蛋白水平降低,而血细胞比容在单采后升高,血清葡萄糖、甘油三酯、血红蛋白水平未改变。这些结果表明,血小板单采会引起血液流变学参数改变,从而影响供体微血管灌注,而NO似乎对观察到的RBC变形性损伤具有保护作用。