红细胞储存损伤的预防：五种不同添加剂溶液的比较。
Prevention of red cell storage lesion: a comparison of five different additive solutions.
机构信息
Sanquin Blood Bank, Department Product and Process Development, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
Sanquin Research, Department Blood Cell Research and Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
出版信息
Blood Transfus. 2017 Sep;15(5):456-462. doi: 10.2450/2017.0371-16. Epub 2017 Apr 10.
BACKGROUND
In Europe, red cell concentrates (RCC) are usually stored in SAGM (saline-adenine-glucose-mannitol). During storage, in vitro red cell quality declines, including lowered energy status and increased cell lysis. Recently, several additive solutions (ASs), designed to diminish the decline in in vitro quality during storage, have been developed. These new solutions have mainly been developed to better maintain red blood cell (RBC) 2,3-biphosphoglycerate (2,3 BPG) levels and energy status during storage. High levels of 2,3 BPG allow for better oxygen release while high energy status is necessary for function and survival of RBC in vivo. In a paired study design, RBC ASs were compared for their ability to provide improved in vitro quality during hypothermic storage.
MATERIALS AND METHODS
For each experiment, 5 whole blood units held overnight were pooled and split. The whole blood units were processed according to the buffy coat method. RBCs were resuspended in either SAGM, PAGGSM, PAG3M, E-Sol 5 or AS-7 and leucoreduced by filtration. RCCs were stored for eight weeks at 2-6 °C and sampled weekly for analysis of in vitro quality parameters.
RESULTS
Red cell concentrates stored in PAG3M, E-Sol 5 and AS-7 showed significantly higher lactate production and higher levels of intracellular adenosine triphosphate (ATP) and total adenylate. 2,3 BPG levels rapidly declined during storage in SAGM and PAGGSM. The decline in 2,3 BPG was inhibited during storage in E-Sol 5 and AS-7, while in PAG3M, 2,3 BPG level increased above the initial level till day 35 and remained detectable till day 56. Haemolysis was comparable for all ASs until day 35, upon prolonged storage, haemolysis in SAGM was higher than with the other ASs. As compared to SAGM, storage in PAGGSM, PAG3M, E-Sol 5 and AS-7 better maintained morphological properties.
DISCUSSION
Storage of RBCs in the new generation ASs yield RBCs with more stable metabolite levels and improved overall quality during storage as compared with RBCs stored in SAGM.
背景
在欧洲，红细胞浓缩物（RCC）通常储存在 SAGM（生理盐水-腺嘌呤-葡萄糖-甘露醇）中。在储存过程中，体外红细胞质量下降，包括能量状态降低和细胞裂解增加。最近，已经开发了几种添加剂溶液（ASs），旨在减少储存过程中体外质量的下降。这些新的解决方案主要是为了更好地维持红细胞（RBC）2,3-二磷酸甘油酸（2,3 BPG）水平和储存过程中的能量状态。高水平的 2,3 BPG 允许更好地释放氧气，而高能状态是 RBC 在体内功能和存活所必需的。在配对研究设计中，比较了 RBC ASs 在低温储存期间提供改善体外质量的能力。
材料和方法
对于每个实验，将过夜保存的 5 个全血单位混合并分成两份。全血单位按白细胞层法处理。将 RBC 悬浮在 SAGM、PAGGSM、PAG3M、E-Sol 5 或 AS-7 中，并通过过滤去除白细胞。RCC 在 2-6°C 下储存 8 周，并每周取样进行体外质量参数分析。
结果
储存于 PAG3M、E-Sol 5 和 AS-7 的 RCC 产生的乳酸明显较高，细胞内三磷酸腺苷（ATP）和总腺苷的水平也较高。在 SAGM 和 PAGGSM 储存过程中，2,3 BPG 水平迅速下降。在 E-Sol 5 和 AS-7 储存过程中，2,3 BPG 的下降得到抑制，而在 PAG3M 中，2,3 BPG 水平在第 35 天之前增加到初始水平以上，并在第 56 天之前仍可检测到。所有 AS 的溶血率在第 35 天之前相似，随着储存时间的延长，SAGM 的溶血率高于其他 AS。与 SAGM 相比，在 PAGGSM、PAG3M、E-Sol 5 和 AS-7 中储存可更好地维持形态学特性。
讨论
与储存于 SAGM 的 RBC 相比，储存于新一代 AS 中的 RBC 具有更稳定的代谢物水平和储存过程中整体质量的提高。
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