Blaze Medical Devices, Ann Arbor, Michigan.
Transfusion. 2014 Mar;54(3 Pt 2):933-41. doi: 10.1111/trf.12457. Epub 2013 Oct 28.
Red blood cell (RBC) storage lesions have been suggested as contributing factors to suboptimal clinical outcomes. While undesirable effects of storage are well documented, their clinical relevance is still debated. Focus on storage time as the sole determinant of RBC quality ignores the variability in cell properties that may depend on factors other than age. Mechanical fragility (MF) aggregately reflects many storage-related functional and structural changes. This study evaluates interdonor versus intradonor variability, throughout storage, of both MF and autohemolysis (AH).
Thirteen uniformly manufactured RBC units were collected initially as whole blood from nonsmoking, group A+, male Caucasian research donors. Mechanical stress was applied using a bead mill with oscillation at 50 Hz over durations varying from 0.5 to 60 minutes. MF profiles were described in terms of percent hemolysis after stresses of specified durations. Two months later, 11 of the 13 donors returned and assays were performed using the same protocol to allow comparison of intradonor versus interdonor variation.
At 5 days postcollection, RBC MF profiles exhibited marked interdonor variability (up to twofold) overall. Both autolysis and MF across all units increased during storage-with rates of these increases varying by up to 10-fold for certain MF variables. Especially high AH and MF were observed for an outlier donor (with p < 0.05), for whom follow-up revealed previously undisclosed hereditary hypertriglyceridemia (levels exceeding approx. 1000 mg/dL).
RBCs, even from similar donors, vary significantly in levels and changes of both AH and MF, the clinical significance of which must still be ascertained. While further study is needed, donors with severe hypertriglyceridemia may not be appropriate as blood donors due to the unacceptable level of hemolysis observed during storage of our affected study subject.
红细胞（RBC）储存损伤被认为是导致临床结局不佳的因素之一。虽然储存的不良影响已有充分记录，但它们的临床相关性仍存在争议。将储存时间作为唯一决定 RBC 质量的因素，忽略了细胞特性的可变性，而这些特性可能取决于年龄以外的因素。机械脆弱性（MF）综合反映了许多与储存相关的功能和结构变化。本研究评估了在整个储存过程中，MF 和自溶血（AH）的同种异体与同种异体供体之间的变异性。
最初从非吸烟的 A+血型男性白种人研究供体收集了 13 个均匀制造的 RBC 单位作为全血。使用珠磨机以 50 Hz 的频率进行振荡，施加机械应力，持续时间从 0.5 分钟到 60 分钟不等。用指定持续时间的应力后的溶血百分比来描述 MF 谱。两个月后，13 名供体中的 11 名返回，并使用相同的方案进行检测，以允许比较同种异体与同种异体供体之间的变异。
在采集后 5 天，总体上 RBC MF 谱表现出明显的同种异体供体间变异性（高达两倍）。在整个储存过程中，自溶血和 MF 都在增加——这些增加的速率在某些 MF 变量中变化高达 10 倍。对于一个异常供体（p < 0.05），观察到特别高的 AH 和 MF，对其进行随访发现了以前未发现的遗传性高甘油三酯血症（水平超过约 1000mg/dL）。
即使来自相似的供体，RBC 在 AH 和 MF 的水平和变化方面也存在显著差异，其临床意义仍需确定。虽然需要进一步研究，但由于我们受影响的研究对象在储存过程中观察到不可接受的溶血水平，因此严重高甘油三酯血症的供体可能不适合作为献血者。
