Department of Surgery, Section of General Surgery, University of Cincinnati, OH.
Department of Surgery, Section of General Surgery, University of Cincinnati, OH.
Surgery. 2021 Mar;169(3):666-670. doi: 10.1016/j.surg.2020.07.022. Epub 2020 Aug 23.
Transfusion of blood products is the ideal resuscitative strategy after hemorrhage. Unfortunately, older packed red blood cells have been associated with increased morbidity and mortality after massive transfusion. These packed red blood cells accumulate biochemical and structural changes known as the red blood cell storage lesions. The effect of washing on the formation of red blood cell storage lesions is unknown. We hypothesized that washing packed red blood cells during storage would decrease the development of the red blood cell storage lesions.
Blood from 8- to 10-week-old male mice donors was stored as packed red blood cells for 14 days. A subset of packed red blood cells were washed with phosphate-buffered saline on storage day 7 and resuspended in AS-1 solution for an additional 7 days as washed packed red blood cells. Subsequently, the packed red blood cells were analyzed for microvesicle release, band-3 erythrocyte membrane integrity protein (Band-3), expression of phosphatidylserine, cell viability (calcein), accumulation of cell-free hemoglobin, and osmotic fragility.
In the washed packed red blood cells group, there was less microvesicle accumulation, greater Band-3 expression, less phosphatidylserine expression, a decrease in cell-free hemoglobin accumulation, and a decrease in osmotic fragility, but no differences in red blood cells viability.
Washing packed red blood cells during storage decreases the accumulation of red blood cell storage lesions. This strategy may lessen the sequelae associated with transfusion of older packed red blood cells.
输血是出血后理想的复苏策略。不幸的是，陈旧的浓缩红细胞与大量输血后发病率和死亡率增加有关。这些浓缩红细胞会积累被称为红细胞储存损伤的生化和结构变化。洗涤对红细胞储存损伤形成的影响尚不清楚。我们假设在储存过程中洗涤浓缩红细胞会减少红细胞储存损伤的发展。
从 8 至 10 周龄雄性小鼠供体采集的血液被储存为浓缩红细胞 14 天。一部分浓缩红细胞在储存第 7 天用磷酸盐缓冲盐水洗涤，并在 AS-1 溶液中重新悬浮，再储存 7 天，即为洗涤后的浓缩红细胞。随后，分析浓缩红细胞的微泡释放、带 3 红细胞膜完整性蛋白 (Band-3)、磷脂酰丝氨酸表达、细胞活力（钙黄绿素）、游离血红蛋白积累和渗透脆性。
在洗涤后的浓缩红细胞组中，微泡积累减少，Band-3 表达增加，磷脂酰丝氨酸表达减少，游离血红蛋白积累减少，渗透脆性降低，但红细胞活力无差异。
在储存过程中洗涤浓缩红细胞可减少红细胞储存损伤的积累。这种策略可能减轻输注陈旧浓缩红细胞相关的后遗症。
