Screening for autologous blood transfusions.
The ratio between the amount of hemoglobin in the mature erythrocyte population and the reticulocytes (RBCHb:RetHb ratio) has previously been suggested as a marker to screen for EPO-abuse. We speculated that the reinfusion of blood would lead to a marked increase in this ratio, making it a valuable parameter in the screening for autologous blood doping. Three bags of blood (approximately 201+/-11 g of Hb) were withdrawn from 16 males and stored at either -80 degrees C (-80 T, n=8) or +4 degrees C (+4 T, n=8) and reinfused 10 weeks or 4 weeks later, respectively. Seven subjects served as controls. Different erythrocyte parameters were measured on a hematological analyzer serially throughout and during a 4 week wash-out period. By using RBCHb:RetHb ratio cut-off limits of 145.7 (1:100) ('suspicious') and 182.9 (1:1000) ('positive'), 35.4% (-80 T) and 19.6% (+4 T) of all samples obtained during a 4 week wash-out period were identified as 'suspicious', and 18.8% (-80 T) and 4.3% (+4 T) as 'positive'. In total, 7 out of 16 (43.8%) subjects had at least one sample exceeding 182.9. Compared to the currently used indirect parameters, the RBCHb:RetHb ratio is the best indicator of autologous blood doping after reinfusion, and the parameter could be used in a testing setting, once stability validation has been performed.
Mørkeberg
J
J
Department of Anaesthesiology, Bispebjerg Hospital, Copenhagen NV, Denmark. jakobmoerkeberg@hotmail.com
Belhage
B
B
Ashenden
M
M
Bornø
A
A
Sharpe
K
K
Dziegiel
M H
MH
Damsgaard
R
R
D000328:Adult; D001793:Blood Preservation / Q000379:methods; D001804:Blood Transfusion, Autologous; D004300:Doping in Sports / Q000379:methods*; D004912:Erythrocytes / Q000378:metabolism; D006454:Hemoglobins / Q000032:analysis* / Q000378:metabolism; D006801:Humans; D008297:Male; D012156:Reticulocytes / Q000378:metabolism; D015813:Substance Abuse Detection / Q000379:methods*; D013696:Temperature; D055815:Young Adult
D006454:Hemoglobins