Solutions for organ perfusion and storage: haemorheologic aspects.
BACKGROUND
The hydroxyethyl starch (HES) contained in University of Wisconsin (UW) solution causes erythrocyte aggregation. The effect of UW on red blood cell (RBC) deformability is still unclear. HES-free preservation solutions, Celsior (CS) and Custodiol (CU) are available. In this study we evaluated whether they really showed a reduced aggregating and stiffening effect on RBCs when compared with UW. We was also evaluated the effect of these solutions on cellular membranes by measuring acetylcholinesterase (AChE), which is a marker of RBC membrane integrity.


METHODS
The determination of RBC aggregation and deformability was performed by a laser-assisted optical rotation cell analyzer (LORCA). AChE measurement was performed with a spectrophotometric technique.


RESULTS
The mean RBC aggregation index (AI) measured in pure blood control samples was 28.00 +/- 0.73%. The AI measured samples containing UW was 38.82 +/- 1.58%. In samples with CS, it was 13.307 +/- 0.64% and in samples with CU the mean AI was 12.47 +/- 0.42%. Also the RBC aggregating time was quicker in presence of UW compared with controls. AChE concentration in blood was 3.043 +/- 0.4 nmol. CS and UW did not produce any significant change; a significant reduction was found when CU was added to blood, namely 1.975 +/- 0.1 nmol (P < .05). The use of UW or CS or CU did not result in any significant change in RBC deformability.


CONCLUSIONS
CS and CU solutions do not aggregate erythrocytes, whereas Wisconsin does massively. CU causes an alteration of RBC cellular membrane as demonstrated by depletion of AChE.
Panzera
P
P
Department of General Surgery and Liver Transplantation, University of Bari, Bari, Italy.
Rotelli
M T
MT
Salerno
A M
AM
Cicco
G
G
Catalano
G
G
D'Elia
G
G
Greco
L
L
Lupo
L
L
Memeo
V
V
D000110:Acetylcholinesterase / Q000097:blood; D000241:Adenosine / Q000009:adverse effects; D000493:Allopurinol / Q000009:adverse effects; D004187:Disaccharides / Q000494:pharmacology; D004573:Electrolytes / Q000494:pharmacology; D004903:Erythrocyte Aggregation / Q000187:drug effects*; D004907:Erythrocyte Deformability / Q000187:drug effects*; D005947:Glucose / Q000494:pharmacology; D005971:Glutamates / Q000494:pharmacology; D005978:Glutathione / Q000009:adverse effects / Q000494:pharmacology; D018056:Hemorheology / Q000187:drug effects*; D006639:Histidine / Q000494:pharmacology; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology*; D007328:Insulin / Q000009:adverse effects; D008353:Mannitol / Q000494:pharmacology; D019188:Organ Preservation Solutions / Q000009:adverse effects*; D011189:Potassium Chloride / Q000494:pharmacology; D011343:Procaine / Q000494:pharmacology; D011887:Raffinose / Q000009:adverse effects; D013997:Time Factors
C039984:Bretschneider cardioplegic solution; C088453:Celsior; D004187:Disaccharides; D004573:Electrolytes; D005971:Glutamates; D006895:Hydroxyethyl Starch Derivatives; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D008353:Mannitol; D006639:Histidine; D011343:Procaine; D000493:Allopurinol; D011189:Potassium Chloride; D000110:Acetylcholinesterase; D005978:Glutathione; D005947:Glucose; D000241:Adenosine; D011887:Raffinose