Gajju Khan Medical College Swabi, Pakistan.
Institute of Basic Medical Sciences, Khyber Medical University.
J Pak Med Assoc. 2020 Dec;70(12(B)):2416-2421. doi: 10.47391/JPMA.676.
This project aimed at determining time-dependent ultrastructural and haematological changes taking place in blood stored in local blood banks of Khyber Pakhtunkhwa.
It was a longitudinal study with repeated measures design. Twenty healthy blood donors participated in this study. An amount of 250ml blood was collected from each donor and stored in Citrate Phosphate Dextrose Adenine-1 (CPDA-1)- containing blood bags. Within first four hours, baseline samples were taken while subsequent samples were obtained at 5 days interval till day 20th. Structural changes in RBCs were observed under light and scanning electron microscope (SEM) at different intervals. Furthermore, haematological parameters and osmotic fragility were also determined.
Remarkable alterations were seen in RBCs morphology. From 5th day onwards, multiple visible spicules were observed on the RBC's outer membrane and more than 2/3rd cells were abnormal at day 20. There was a significant reduction in RBCs count and haemoglobin concentration while the remaining parameters remained unchanged. Osmotic fragility increased significantly over time, with <1% haemolysis noted in baseline samples as compared to 2.4% haemolysis on day 20th (p≤0.0001).
Prolonged storage of blood results in distorted RBCs morphology and increased fragility. Transfusion of such cells would potentially result in rapid lysis in patients with hepatosplenomegaly and conditions requiring multiple blood transfusions.
本项目旨在确定在开伯尔-普赫图赫瓦省当地血库储存的血液中发生的与时间相关的超微结构和血液学变化。
这是一项具有重复测量设计的纵向研究。 20 名健康献血者参与了这项研究。从每位献血者采集 250ml 血液，并储存在含有柠檬酸钠磷酸盐葡萄糖腺嘌呤-1（CPDA-1）的血袋中。在最初的 4 小时内，采集基线样本，然后每隔 5 天采集一次样本，直到第 20 天。在不同时间间隔下，通过光镜和扫描电子显微镜（SEM）观察 RBC 的结构变化。此外，还测定了血液学参数和渗透脆性。
在 RBC 形态上观察到明显的改变。从第 5 天开始，在 RBC 外膜上观察到多个可见的刺突，并且在第 20 天超过 2/3 的细胞异常。 RBC 计数和血红蛋白浓度显著降低，而其余参数保持不变。渗透脆性随时间显著增加，与第 0 天相比，第 20 天的基础样本溶血率<1%，而溶血率为 2.4%（p≤0.0001）。
血液的长期储存会导致 RBC 形态扭曲和脆性增加。输注此类细胞可能会导致肝脾肿大和需要多次输血的患者中的细胞迅速溶解。
