Mannitol-adenine-phosphate: a novel solution for intraoperative blood salvage.
BACKGROUND
Intraoperative blood salvage (IBS) procedures include washing with normal saline (NS), which may deplete red blood cell (RBC) nutrients. The mannitol-adenine-phosphate (MAP) solution, commonly used for RBC preservation, provides glycolytic substrates; therefore, MAP should be a better solution than NS in IBS. In this study, we determined whether using MAP could reduce washing-associated RBC damage and destruction.


METHODS
Adenine nucleotide contents, RBC morphology, and plasma free hemoglobin (PF-Hb) level of RBCs treated with NS or MAP solution were compared under three conditions: (1) 4-hour preservation of fresh blood from healthy volunteers, (2) collection from the shed blood of patients, and 3) incubation of the collected shed blood with plasma.


RESULTS
Adenine nucleotide level and RBC elongation index were greater and PF-Hb level was lower in MAP groups than NS groups (p < 0.05) after preservation and incubation. In NS, RBCs lost their deformability and became stomatocytes, and even RBC "ghosts" 48 hours after incubation, while they remained normal in MAP solution.


CONCLUSIONS
The MAP solution helps preserve RBC morphology and function, and reduces hemolysis, possibly due to improved energy production. Therefore, MAP should replace NS during IBS.
Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China; Department of Anesthesiology, Three Gorges Central Hospital of Chongqing, Chongqing, China.
Ping
P
Yang
Jing
J
Zhou
Yi
Y
Kang
Lina
L
Gong
Jie
J
Zhang
Jie
J
Yu
Xiaorong
X
Yin
Chongwei
C
Zhang
Guangyue
G
Liu
Jin
J
Liu
Lei
L
Du
D000225:Adenine / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use; D001793:Blood Preservation / Q000379:methods*; D048430:Cell Shape / Q000187:drug effects; D002478:Cells, Cultured; D004353:Drug Evaluation, Preclinical; D004907:Erythrocyte Deformability / Q000187:drug effects; D004912:Erythrocytes / Q000166:cytology / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008355:Mannitol Phosphates / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D057725:Operative Blood Salvage / Q000379:methods*
D008355:Mannitol Phosphates; D000225:Adenine