title: Microhemodynamic aberrations created by transfusion of stored blood.
abstract: BACKGROUND
  Human red blood cells (RBCs) can be stored for up to 42 days under controlled conditions. Physical and chemical changes occur during RBC storage, altering their function. This study links stored cell mechanical changes with hemodynamic functional alterations upon transfusion.
  
  
  METHODS
  Mechanical properties of fresh and stored RBCs were evaluated in vitro. Their transfusion effects were evaluated in vivo using intravital microscopy of the rat's cremaster muscle preparation. Rats were hemodiluted to 30% hematocrit, to mimic an anemic state before transfusion, and then exchange-transfused with fresh or stored cells.
  
  
  RESULTS
  In vitro studies on rheology and oxygen affinity of stored cells confirmed previously published results. Storage was found to modify static and dynamic RBC mechanic behavior. After transfusion, systemic hemodynamics were similar for fresh and stored cells; however, microvascular hemodynamics were drastically affected by stored cells. Stored cells reduced blood flow and oxygen delivery. Additionally, the presence of stored cells in circulation affected cell-to-cell and cell-to-wall interactions and affected cell hydrodynamics. Stored cells disrupted the RBC cell-free layer and wall shear stress signals.
  
  
  CONCLUSIONS
  The reduced cell deformability due to RBC "storage lesions" caused pathologic changes in microvascular hemodynamics, endothelial cell mechanotransduction, and RBC dynamics. Thus, the mechanical changes of blood-banked cells can limit transfusion ability to achieve its intended goal.
authors.affiliation: Department of Bioengineering, University of California San Diego, La Jolla, California.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Yalcin
authors.forename: Daniel
authors.initials: D
authors.lastname: Ortiz
authors.forename: Amy G
authors.initials: AG
authors.lastname: Tsai
authors.forename: Paul C
authors.initials: PC
authors.lastname: Johnson
authors.forename: Pedro
authors.initials: P
authors.lastname: Cabrales
mesh_terms: D000818:Animals; D001793:Blood Preservation / Q000009:adverse effects*; D002478:Cells, Cultured; D055119:Elastic Modulus; D004907:Erythrocyte Deformability; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008833:Microcirculation / Q000502:physiology*; D010100:Oxygen / Q000378:metabolism; D051381:Rats; D017207:Rats, Sprague-Dawley; D033081:Shear Strength; D065227:Transfusion Reaction; D014652:Vascular Diseases / Q000209:etiology*
chemical_list: D010100:Oxygen
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