Section of Cell Biology and Biophysics, Department of Biology, National and Kapodistrian University of Athens, Athens, Greece.
Laboratory of Microbiology, Department of Medical Laboratories, Technological and Educational Institute of Athens, Athens, Greece.
Blood Transfus. 2017 Sep;15(5):447-455. doi: 10.2450/2017.0332-16. Epub 2017 Apr 10.
To preserve cellular integrity and avoid bacterial growth, storage and transfer of blood and blood products follow strict guidelines in terms of temperature control. We evaluated the impact of ineligible warming of whole blood donations on the quality of blood components.
One-hundred and twenty units of whole blood (WB) from eligible blood donors were collected in CPDA-1 and stored at 4±2 °C. During shipment to the blood processing centre, a gradual warming up to 17 °C was recorded within a period of less than eight hours. The warmed units were processed to packed red blood cells (PRBCs) or stored as WB units at 4±2 °C. In-bag haemolysis, osmotic fragility (mean corpuscular fragility, MCF) and bacterial growth were assessed in blood and blood components throughout the storage period.
Normal basal and early storage levels of haemolysis were recorded in both PRBC and WB units. Thereafter, PRBCs exhibited higher average in-bag haemolysis and MCF index compared to the WB units throughout the storage. Moreover, 14.3 and 52.4% of the PRBC units exceeded the upper permissible limit of 0.8% haemolysis at the middle (1.220±0.269%) or late (1.754±0.866%) storage period, respectively. MCF index was similar in all PRBCs at the middle of storage but significantly lower in the non-haemolysed compared to the haemolysed units of PRBCs on the last days. The fragility of stored RBCs was proportional to the donor-related values of day 2 samples (r=0.861, p<10). In the qualified PRBCs, MCF was correlated with haemolysis at every time point of the storage period (r=0.332, p<0.050). Bacterial growth was detected by blood culture in two units of PRBCs.
Transient, gradient warming of whole blood from 4 to 17 °C led to increased incidence of in-bag haemolysis in PRBC but not in WB units. Haemolysis is a multi-parametric phenotype of stored blood, and MCF is a donor-related and highly dynamic measure that can, in part, predict the storage lesion.
为了保持细胞完整性并避免细菌生长，血液和血液制品的储存和运输都需要严格控制温度。我们评估了全血供体不合适的升温对血液成分质量的影响。
将 120 单位 CPDA-1 保存的合格献血者全血在 4±2°C 下储存。在运输到血液处理中心的过程中，在不到 8 小时的时间内记录到逐渐升温至 17°C。将升温的单位加工成浓缩红细胞（PRBC）或作为 4±2°C 的全血单位储存。在整个储存期间，评估血液和血液成分的袋内溶血、渗透脆性（平均红细胞脆性，MCF）和细菌生长。
PRBC 和 WB 单位均记录到正常的基础和早期储存水平溶血。此后，PRBC 单位在整个储存过程中比 WB 单位表现出更高的平均袋内溶血和 MCF 指数。此外，在储存中期（1.220±0.269%）或晚期（1.754±0.866%），14.3%和 52.4%的 PRBC 单位超过了 0.8%溶血的上限，分别为 1.8%。在中期，所有 PRBC 的 MCF 指数相似，但在最后几天，与非溶血的 PRBC 单位相比，溶血的 PRBC 单位的 MCF 指数明显较低。储存红细胞的脆性与第 2 天样本的供体相关值成正比（r=0.861，p<10）。在合格的 PRBC 中，MCF 与储存期内每个时间点的溶血相关（r=0.332，p<0.050）。通过血液培养在两个 PRBC 单位中检测到细菌生长。
全血从 4°C 到 17°C 的短暂、梯度升温导致 PRBC 袋内溶血的发生率增加，但 WB 单位没有。溶血是储存血液的多参数表型，MCF 是与供体相关的高度动态指标，在一定程度上可以预测储存损伤。
