Washing stored red blood cells in an albumin solution improves their morphologic and hemorheologic properties.
BACKGROUND
Prolonged storage of red blood cells (RBCs) leads to storage lesions, which may impair clinical outcomes after transfusion. A hallmark of storage lesions is progressive echinocytic shape transformation, which can be partially reversed by washing in albumin solutions. Here we have investigated the impact of this shape recovery on biorheologic variables.


METHODS
RBCs stored hypothermically for 6 to 7 weeks were washed in a 1% human serum albumin (HSA) solution. RBC deformability was measured with osmotic gradient ektacytometry. The viscosity of RBC suspensions was measured with a Couette-type viscometer. The flow behavior of RBCs suspended at 40% hematocrit was tested with an artificial microvascular network (AMVN).


RESULTS
Washing in 1% albumin reduced higher degrees of echinocytes and increased the frequency of discocytes, thereby shifting the morphologic index toward discocytosis. Washing also reduced RBC swelling. This shape recovery was not seen after washing in saline, buffer, or plasma. RBC shape normalization did not improve cell deformability measured by ektacytometry, but it tended to decrease suspension viscosities at low shear rates and improved the perfusion of an AMVN.


CONCLUSIONS
Washing of stored RBCs in a 1% HSA solution specifically reduces echinocytosis, and this shape recovery has a beneficial effect on microvascular perfusion in vitro. Washing in 1% albumin may represent a new approach to improving the quality of stored RBCs and thus potentially reducing the likelihood of adverse clinical outcomes associated with transfusion of blood stored for longer periods of time.
Department of Internal Medicine, Kantonsspital Graubünden, Chur, Switzerland.
Walter H
WH
Reinhart
Department of Biomedical Engineering, University of Houston, Houston, Texas.
Nathaniel Z
NZ
Piety
Division of Hematology, University Hospital of Zürich.
Jeremy W
JW
Deuel
Institute of Veterinary Physiology, University of Zürich, Zürich, Switzerland.
Asya
A
Makhro
Department of Internal Medicine, Kantonsspital Graubünden, Chur, Switzerland.
Thomas
T
Schulzki
Institute of Veterinary Physiology, University of Zürich, Zürich, Switzerland.
Nikolay
N
Bogdanov
Division of Hematology, University Hospital of Zürich.
Jeroen S
JS
Goede
Institute of Veterinary Physiology, University of Zürich, Zürich, Switzerland.
Anna
A
Bogdanova
Department of Biomedical Engineering, University of Houston, Houston, Texas.
Rajaa
R
Abidi
Department of Biomedical Engineering, University of Houston, Houston, Texas.
Sergey S
SS
Shevkoplyas
D000225:Adenine / Q000494:pharmacology; D000255:Adenosine Triphosphate / Q000097:blood; D001793:Blood Preservation / Q000379:methods*; D002021:Buffers; D048430:Cell Shape; D004909:Erythrocyte Indices; D017707:Erythrocyte Transfusion; D004912:Erythrocytes / Q000166:cytology / Q000187:drug effects*; D004913:Erythrocytes, Abnormal / Q000648:ultrastructure; D005947:Glucose / Q000494:pharmacology; D005978:Glutathione / Q000097:blood; D006151:Guanosine / Q000494:pharmacology; D018056:Hemorheology; D006801:Humans; D066298:In Vitro Techniques; D008353:Mannitol / Q000494:pharmacology; D008953:Models, Anatomic; D010084:Oxidation-Reduction; D010477:Perfusion; D010949:Plasma; D012034:Refrigeration; D012709:Serum Albumin / Q000494:pharmacology*; D012965:Sodium Chloride / Q000494:pharmacology; D012996:Solutions
C037839:ADSOL; D002021:Buffers; C430585:PAGGS-M solution; D012709:Serum Albumin; D012996:Solutions; D006151:Guanosine; D008353:Mannitol; D012965:Sodium Chloride; D000255:Adenosine Triphosphate; D005978:Glutathione; D005947:Glucose; D000225:Adenine