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Erythrocyte Concentrates Recovered from Under-Collected Whole Blood: Experimental and Clinical Results



Published on:2016-11-28   Views:317

Abstract

BACKGROUND:Although periodic blood shortages are widespread inmajor Chinese cities, approximately 1 x 10(5) U of whole blood are discardedyearly because of under-collection. To reduce the wastage of acid citratedextrose solution B (ACD-B) anticoagulated under-collected whole blood (UC-WB),this study was performed to elucidate the effect of extracellular pH andholding time on erythrocyte quality. Mannitol-adenine-phosphate (MAP)erythrocyte concentrates (UC-RBCs) were prepared with UC-WB to assess thesafety and efficacy of this component.

METHODS:The effect of the different extracellular pH levelsand storage times on erythrocytes was assessed by fluorescent probes, SDS-PAGEelectrophoresis, electron microscopy and spectroscopy. In vitro properties of34 UC-RBCs that were prepared with UC-WB at different times after collectionwere analyzed and compared to normal RBCs during 35 days of storage. Theresults of transfusion with UC-RBCs and the incidence of adverse reactions in49 patients were determined.

RESULTS:1) Low extracellular pH levels and long storagetime induced increases in RBC fluorescence polarization and meanmicroviscosity, changes in membrane fluidity, band 1, 2 and 3 proteinexpression, and erythrocyte morphology. 2) During storage for 35 days,difference in between-subjects effects of K+, hemolysis and supernatanterythrocyte membrane protein (EMP) were statistically significant (P = 0.041,0.007 and 0.002, respectively), while the differences between these parametersin the 4 h group and comparable controls were less significant. 3) Clinicaldata from 49 patients confirmed that transfusions with UC-RBCs weresatisfactory with no adverse reactions.

CONCLUSION:These results suggest that it is feasible toprepare RBCs with ACD-B anticoagulated UC-WB at a minimum of 66% volume of thelabeled collection. It was effective and safe to transfuse the UC-RBCs preparedwithin 4 h after collection and stored within 7 days. The use of UC-WB would bea welcome addition to limited blood resources in China.