Rejuvenation improves roller pump-induced physical stress resistance of fresh and stored red blood cells.
BACKGROUND
Retrospective studies on transfusion recipients suggested that transfusion of older red blood cells (RBCs) was associated with higher morbidity. Similar studies were also done on cardiac surgery patients who were placed on cardiac bypass pumps. It is possible that stored RBCs are more fragile and could be more easily damaged by these pumps, thus leading to additional morbidity.


METHODS
Fresh and stored (42 days) RBCs, rejuvenated and nonrejuvenated, were compared in resistance to physical stress, induced by a roller pump, and osmotic fragility changes during physical stress to model RBCs going through cardiac bypass instruments. In addition, posttransfusion in vivo recovery was evaluated in an immunodeficient mouse model to minimize species differences between transfusion product and recipient.


RESULTS
Fresh RBCs were more resistant to both osmotic and physical stress than stored cells. After 2 hours of physical stress, the osmotic stress resistance of fresh cells declined and was the same as for stored cells. Rejuvenated fresh cells did not demonstrate a decline in osmotic resistance during the stress test and both fresh and stored cells had the same improved resistance to osmotic stress before and after the physical stress. Rejuvenation slightly improved recovery of fresh RBCs but almost doubled the recovery of stored cells in the mouse model.


CONCLUSIONS
Our studies suggest that rejuvenation improves roller pump-induced physical and osmotic stress resistance of stored RBCs.
Laboratory of Cellular Hematology, Division of Hematology, Center for Biologics Evaluation and Research, Food and Drug Administration, Rockville, Maryland 20852-1448, USA. Monique.Gelderman-Fuhrmann@fda.hhs.gov
Monique P
MP
Gelderman
Jaroslav G
JG
Vostal
D000818:Animals; D001793:Blood Preservation / Q000379:methods*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D004912:Erythrocytes / Q000166:cytology / Q000502:physiology*; D006801:Humans; D007038:Hypotonic Solutions; D007260:Infusion Pumps / Q000009:adverse effects*; D051379:Mice; D016513:Mice, SCID; D023421:Models, Animal; D009996:Osmotic Fragility; D009997:Osmotic Pressure / Q000502:physiology; D012060:Rejuvenation / Q000502:physiology*; D012965:Sodium Chloride; D013314:Stress, Mechanical
D007038:Hypotonic Solutions; D012965:Sodium Chloride