Rejuvenation of stored human red blood cells reverses the renal microvascular oxygenation deficit in an isovolemic transfusion model in rats.
BACKGROUND
Storage of red blood cells (RBCs) results in various biochemical changes, including a decrease in cellular adenosine triphosphate and 2,3-diphosphoglycerate acid. Previously it was shown that stored human RBCs show a deficit in the oxygenation of the microcirculation in the gut of anesthetized rats. In this study, the effect of RBCs on rat kidney oxygenation and the effect of rejuvenation of stored RBCs on their ability to deliver oxygen were investigated.


METHODS
Washed RBCs, derived from leukoreduced RBCs stored in saline-adenine-glucose-mannitol, were tested in an isovolemic transfusion model in rats after hemodilution until 30 percent hematocrit (Hct). The cells were derived from RBCs stored for up 3 days or from RBCs stored for 5 to 6 weeks with or without incubation in Rejuvesol to rejuvenate the cells. Renal microvascular oxygen concentrations (microPO(2)) were determined by Pd-porphyrin phosphorescence lifetime measurements.


RESULTS
Isovolemic transfusion exchange of 5- to 6-week-stored RBCs resulted in a significantly larger decrease in renal microPO(2) than RBCs stored for up to 3 days: 16.1 +/- 2.3 mmHg versus 7.1 +/- 1.5 mmHg, respectively (n = 5). Rejuvenation of stored RBCs completely prevented this deficit in kidney oxygenation. The differences in oxygen delivery were not due to different recoveries of the human RBCs in the rat circulation.


CONCLUSIONS
This study shows that the storage-induced deficit of human RBCs to oxygenate the rat kidney microcirculation at reduced Hct is completely reversible. Prevention of metabolic changes during storage is therefore a valid approach to prevent this deficit.
Raat
Nicolaas J H
NJ
Department of Physiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Hilarius
Petra M
PM
Johannes
Tanja
T
de Korte
Dirk
D
Ince
Can
C
Verhoeven
Arthur J
AJ
D000255:Adenosine Triphosphate / Q000378:metabolism; D000818:Animals; D001793:Blood Preservation; D001803:Blood Transfusion / Q000379:methods*; D004912:Erythrocytes / Q000502:physiology*; D006801:Humans; D007668:Kidney / Q000098:blood supply* / Q000378:metabolism*; D008297:Male; D023421:Models, Animal; D010100:Oxygen / Q000378:metabolism*; D051381:Rats; D017208:Rats, Wistar
D000255:Adenosine Triphosphate; D010100:Oxygen