Mansouri Taleghani B, Grossmann R, Waltenberger G, Geise W, Langer R, Henrich H A, Wiebecke D
Abteilung für Transfusionsmedizin und Immunhämatologie in der Chirurgischen Universitätsklinik, Würzburg.
Beitr Infusionsther Transfusionsmed. 1996;33:141-4.
Rheological integrity is one of the essentials for red blood cells (rbc) in capillary circulation. The influences of metabolical/biochemical changes of rbc on their rheological properties are well known, but (to our knowledge) until now there are no published studies, which cover both quality aspects of packed rbc (prbc) in additive solutions. According to our standard operating procedures (SOP) we prepared prbc in additive solution (SAG-M) and plasma from 16 regular blood donations. The buffy coat was discharged. Following parameters were measured on day 1, 14 and 28: extracellular pH, ATP and 2,3-DPG content of rbc, prbc-viskosity, -filterability, -aggregability and filter clogging rate. For examination of the filterability a 5% rbc-suspension in phoshate buffered solution was prepared, the remaining tests were performed with rbc-samples adjusted to a hematokrit of 40% with fresh frozen autologous plasma. In correlation with the depletion of ATP a decrease of rbc flexibility and changes of shape (for example spherocytosis) are well known from the literature. Our results confirm the assumed time dependent deterioration of rheological patterns of prbc in SAG-M, reflecting in an increase of rbc-viscosity and filter clogging rate and a decrease of rbc-filterability and -aggregability. We also observed the expected decrease of pH, ATP and 2,3-DPG during storage. The influences of biochemical changes on rheological alterations are discussed. Therefore we recommend on demand rheological examinations in addition to metabolical/biochemical analyses for an extended quality assurance program, for instance for testing new additive solutions or major changes of SOP.
流变学完整性是红细胞在毛细血管循环中的基本要素之一。红细胞代谢/生化变化对其流变学特性的影响是众所周知的，但据我们所知，到目前为止，尚无已发表的研究涵盖添加剂溶液中浓缩红细胞（prbc）的质量方面。根据我们的标准操作程序（SOP），我们从16次常规献血中制备了添加剂溶液（SAG-M）中的prbc和血浆。去除了白膜层。在第1天、第14天和第28天测量了以下参数：红细胞的细胞外pH值、ATP和2,3-二磷酸甘油酸（2,3-DPG）含量、prbc粘度、过滤性、聚集性和滤器堵塞率。为了检测过滤性，制备了磷酸盐缓冲溶液中5%的红细胞悬液，其余测试使用新鲜冷冻自体血浆将红细胞样本调整至血细胞比容为40%后进行。从文献中可知，与ATP消耗相关的是红细胞柔韧性下降和形状改变（例如球形红细胞症）。我们的结果证实了SAG-M中prbc流变学模式随时间的恶化，表现为红细胞粘度和滤器堵塞率增加，红细胞过滤性和聚集性降低。我们还观察到储存期间pH值、ATP和2,3-DPG如预期那样下降。讨论了生化变化对流变学改变的影响。因此，我们建议除了进行代谢/生化分析外，按需进行流变学检查，以开展扩展的质量保证计划，例如用于测试新的添加剂溶液或SOP的重大变化。
