title: Transfusion of banked red blood cells and the effects on hemorrheology and microvascular hemodynamics in anemic hematology outpatients.
abstract: BACKGROUND
  The aim of this study was to investigate the effects of red blood cell (RBC) transfusion on the hemorrheologic properties and microcirculatory hemodynamics in anemic hematology outpatients receiving 2 to 4 RBC units of either "fresh" (leukoreduced storage for less than 1 week) or "aged" (leukoreduced storage for 3-4 weeks) RBCs.
  
  
  METHODS
  Measurements were performed before and 30 minutes after RBC transfusion in hematology outpatients. Leukoreduced RBC suspensions were stored in saline-adenine-glucose-mannitol (SAGM) additive solution. Whole blood viscosity was measured using Couette low-shear viscometry, RBC deformability and aggregability were measured using laser-assisted optical rotational cell analysis, and microcirculatory density and perfusion were assessed using sidestream dark field imaging.
  
  
  RESULTS
  One group of patients (n = 10) received a median (interquartile range) of 3 (2-3) RBC bags that were stored for 7 (5-7) days (fresh) and the other group of patients (n = 10) received 3 (3-3) RBC bags that were stored for 23 (22-28) days (aged). After transfusion of fresh versus aged RBCs, hematocrit increased to 32 ± 3% versus 31 ± 2% (p < 0.363), whole blood viscosity increased to 4.2 ± 0.4 Pa/sec versus 4.2 ± 0.6 Pa/sec (p < 0.912), RBC deformability index remained unaffected, RBC aggregability index increased to 55 ± 10 versus 55 ± 13 (p = 0.967), microcirculatory flow remained unaffected, and microcirculatory density increased to 19.3 ± 2.5 mm/mm(2) versus 18.7 ± 1.9 mm/mm(2) (p = 0.595), respectively.
  
  
  CONCLUSIONS
  Storing leukoreduced SAGM-suspended RBCs for 3 to 4 weeks did not affect their ability to improve hemorrheologic properties and microcirculatory hemodynamics in our small group of anemic hematology outpatients. Larger studies are needed to confirm this finding.
authors.affiliation: Department of Translational Physiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Koray
authors.initials: K
authors.lastname: Yürük
authors.forename: Dan M J
authors.initials: DM
authors.lastname: Milstein
authors.forename: Rick
authors.initials: R
authors.lastname: Bezemer
authors.forename: Sebastiaan A
authors.initials: SA
authors.lastname: Bartels
authors.forename: Bart J
authors.initials: BJ
authors.lastname: Biemond
authors.forename: Can
authors.initials: C
authors.lastname: Ince
mesh_terms: D000225:Adenine; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood / Q000503:physiopathology* / Q000628:therapy*; D001771:Blood Banks; D001793:Blood Preservation; D016922:Cellular Senescence; D015925:Cryopreservation; D017707:Erythrocyte Transfusion; D005260:Female; D005947:Glucose; D006439:Hemodynamics / Q000502:physiology; D018056:Hemorheology / Q000502:physiology*; D006801:Humans; D047589:Leukocyte Reduction Procedures; D008297:Male; D008353:Mannitol; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D009055:Mouth / Q000098:blood supply; D010045:Outpatients; D012965:Sodium Chloride
chemical_list: C037839:ADSOL; D008353:Mannitol; D012965:Sodium Chloride; D005947:Glucose; D000225:Adenine