title: Red Cell Properties after Different Modes of Blood Transportation.
abstract: Transportation of blood samples is unavoidable for assessment of specific parameters in blood of patients with rare anemias, blood doping testing, or for research purposes. Despite the awareness that shipment may substantially alter multiple parameters, no study of that extent has been performed to assess these changes and optimize shipment conditions to reduce transportation-related artifacts. Here we investigate the changes in multiple parameters in blood of healthy donors over 72 h of simulated shipment conditions. Three different anticoagulants (K3EDTA, Sodium Heparin, and citrate-based CPDA) for two temperatures (4°C and room temperature) were tested to define the optimal transportation conditions. Parameters measured cover common cytology and biochemistry parameters (complete blood count, hematocrit, morphological examination), red blood cell (RBC) volume, ion content and density, membrane properties and stability (hemolysis, osmotic fragility, membrane heat stability, patch-clamp investigations, and formation of micro vesicles), Ca(2+) handling, RBC metabolism, activity of numerous enzymes, and O2 transport capacity. Our findings indicate that individual sets of parameters may require different shipment settings (anticoagulants, temperature). Most of the parameters except for ion (Na(+), K(+), Ca(2+)) handling and, possibly, reticulocytes counts, tend to favor transportation at 4°C. Whereas plasma and intraerythrocytic Ca(2+) cannot be accurately measured in the presence of chelators such as citrate and EDTA, the majority of Ca(2+)-dependent parameters are stabilized in CPDA samples. Even in blood samples from healthy donors transported using an optimized shipment protocol, the majority of parameters were stable within 24 h, a condition that may not hold for the samples of patients with rare anemias. This implies for as short as possible shipping using fast courier services to the closest expert laboratory at reach. Mobile laboratories or the travel of the patients to the specialized laboratories may be the only option for some groups of patients with highly unstable RBCs.
authors.affiliation: Red Blood Cell Research Group, Institute of Veterinary Physiology, Vetsuisse Faculty and the Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich Zurich, Switzerland.
authors.forename: Asya
authors.initials: A
authors.lastname: Makhro
authors.affiliation: Department of Clinical Chemistry and Hematology, University Medical Center Utrecht Utrecht, Netherlands.
authors.forename: Rick
authors.initials: R
authors.lastname: Huisjes
authors.affiliation: Department of Clinical Chemistry and Hematology, University Medical Center Utrecht Utrecht, Netherlands.
authors.forename: Liesbeth P
authors.initials: LP
authors.lastname: Verhagen
authors.affiliation: Red Cell Pathology Unit, Hospital Clínic de Barcelona Barcelona, Spain.
authors.forename: María Del Mar
authors.initials: Mdel M
authors.lastname: Mañú-Pereira
authors.affiliation: Red Cell Pathology Unit, Hospital Clínic de Barcelona Barcelona, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Llaudet-Planas
authors.affiliation: Research Centre for Molecular Imaging and Screening, Medical School, Saarland University Homburg/Saar, Germany.
authors.forename: Polina
authors.initials: P
authors.lastname: Petkova-Kirova
authors.affiliation: Research Centre for Molecular Imaging and Screening, Medical School, Saarland University Homburg/Saar, Germany.
authors.forename: Jue
authors.initials: J
authors.lastname: Wang
authors.affiliation: Saarland University Hospital, Institute for Clinical Hemostaseology and Transfusion-Medicine Homburg/Saar, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Eichler
authors.affiliation: Red Blood Cell Research Group, Institute of Veterinary Physiology, Vetsuisse Faculty and the Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich Zurich, Switzerland.
authors.forename: Anna
authors.initials: A
authors.lastname: Bogdanova
authors.affiliation: Department of Clinical Chemistry and Hematology, University Medical Center Utrecht Utrecht, Netherlands.
authors.forename: Richard
authors.initials: R
authors.lastname: van Wijk
authors.affiliation: Red Cell Pathology Unit, Hospital Clínic de Barcelona Barcelona, Spain.
authors.forename: Joan-Lluís
authors.initials: JL
authors.lastname: Vives-Corrons
authors.affiliation: Research Centre for Molecular Imaging and Screening, Medical School, Saarland UniversityHomburg/Saar, Germany; Dynamics of Fluids, Experimental Physics, Saarland UniversitySaarbruecken, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Kaestner
keywords: athlete biological passport; calcium homeostasis; micro-vesicle; osmotic gradient; rare anaemias