Barshtein Gregory, Rasmusen Tanja L, Zelig Orly, Arbell Dan, Yedgar Saul
Department of Biochemistry, Faculty of Medicine, Hebrew University, Jerusalem, Israel.
Blood Bank, Hadassah-Hebrew University Hospital, Jerusalem, Israel.
Transfus Med. 2020 Dec;30(6):492-496. doi: 10.1111/tme.12725. Epub 2020 Oct 4.
This study aimed to examine the donor-to-donor variability in the deformability of red blood cells (RBCs) from freshly collected blood donations (F-RBC) and packed RBCs.
Packed RBCs are supplied for transfusion by the first-in-first-out (FIFO) criterion, assuming that their quality is the same for packed RBCs with equal storage duration. To challenge this notion, we determined the deformability of F-RBC and packed RBCs stored for different durations.
Three RBC groups were employed: A. 79 samples of F-RBC; B. 76 samples of packed RBC units, randomly used for transfusion at different storage durations; and C. 65 samples of outdated packed RBCs stored for 35 to 37 days. All packed RBC units were non-leukofiltrated and stored in Citrate-phosphate-dextrose solution with adenine (CPDA-1). RBC deformability was determined using a computerised cell-flow properties analyser, which monitors the shape change of cells directly visualised in a narrow-gap flow chamber and provides the cells' deformability distribution in a large RBC population.
The F-RBC deformability exhibited a wide-range inter-donor variability. The cold storage of packed RBCs exerted a mild reduction of deformability, which became significant, compared to the initial inter-donor variability, only after 3 weeks of storage.
Packed RBCs are generally supplied for transfusion by the FIFO criterion based on the assumption that the storage duration is a key factor of RBC quality. This study demonstrates that the deformability of red blood cells is significantly different in donors, and substantial variability persists throughout the entire process of their storage. Therefore, the FIFO criterion is not sufficient for assessing the RBC deformability, which should, therefore, be specifically characterised for each unit.
本研究旨在检测新鲜采集的血液捐献红细胞（F-RBC）和浓缩红细胞中红细胞（RBC）变形性的供者间变异性。
浓缩红细胞按先进先出（FIFO）标准供应输血，假定储存时间相同的浓缩红细胞质量相同。为了挑战这一观念，我们测定了不同储存时间的F-RBC和浓缩红细胞的变形性。
采用三组红细胞：A. 79份F-RBC样本；B. 76份浓缩红细胞单位样本，在不同储存时间随机用于输血；C. 65份储存35至37天的过期浓缩红细胞样本。所有浓缩红细胞单位均未进行白细胞过滤，储存在含腺嘌呤的枸橼酸盐-磷酸盐-葡萄糖溶液（CPDA-1）中。使用计算机化细胞流动特性分析仪测定红细胞变形性，该分析仪监测在窄间隙流动室中直接可视化的细胞形状变化，并提供大量红细胞群体中细胞的变形性分布。
F-RBC变形性在供者间表现出广泛的变异性。浓缩红细胞的冷藏使变形性略有降低，与初始供者间变异性相比，仅在储存3周后才变得显著。
浓缩红细胞通常按FIFO标准供应输血，基于储存时间是红细胞质量关键因素的假设。本研究表明，红细胞变形性在供者之间存在显著差异，并且在其整个储存过程中持续存在很大变异性。因此，FIFO标准不足以评估红细胞变形性，因此，应针对每个单位具体表征其变形性。
