Evolution of adverse changes in stored RBCs

@article{citeulike:1884709, abstract = {Recent studies have underscored questions about the balance of risk and benefit of RBC transfusion. A better understanding of the nature and timing of molecular and functional changes in stored RBCs may provide strategies to improve the balance of benefit and risk of RBC transfusion. We analyzed changes occurring during RBC storage focusing on RBC deformability, RBC-dependent vasoregulatory function, and S-nitrosohemoglobin (SNO-Hb), through which hemoglobin (Hb) O2 desaturation is coupled to regional increases in blood flow in vivo (hypoxic vasodilation). Five hundred ml of blood from each of 15 healthy volunteers was processed into leukofiltered, additive solution 3-exposed RBCs and stored at 16{degrees}C according to AABB standards. Blood was subjected to 26 assays at 0, 3, 8, 24 and 96 h, and at 1, 2, 3, 4, and 6 weeks. RBC SNO-Hb decreased rapidly (1.2 x 104 at 3 h vs. 6.5 x 104 (fresh) mol S-nitrosothiol (SNO)/mol Hb tetramer (P = 0.032, mercuric-displaced photolysis-chemiluminescence assay), and remained low over the 42-day period. The decline was corroborated by using the carbon monoxide-saturated copper-cysteine assay [3.0 x 105 at 3 h vs. 9.0 x 105 (fresh) mol SNO/mol Hb]. In parallel, vasodilation by stored RBCs was significantly depressed. RBC deformability assayed at a physiological shear stress decreased gradually over the 42-day period (P < 0.001). Time courses vary for several storage-induced defects that might account for recent observations linking blood transfusion with adverse outcomes. Of clinical concern is that SNO levels, and their physiological correlate, RBC-dependent vasodilation, become depressed soon after collection, suggesting that even "fresh" blood may have developed adverse biological characteristics. 10.1073/pnas.0708160104}, author = {Bennett-Guerrero, Elliott and Veldman, Tim H. and Doctor, Allan and Telen, Marilyn J. and Ortel, Thomas L. and Reid, Scott T. and Mulherin, Melissa A. and Zhu, Hongmei and Buck, Raymond D. and Califf, Robert M. and Mcmahon, Timothy J. }, citeulike-article-id = {1884709}, doi = {http://dx.doi.org/10.1073/pnas.0708160104}, journal = {Proceedings of the National Academy of Sciences}, keywords = {nitric\_oxide}, month = {October}, number = {43}, pages = {17063--17068}, posted-at = {2007-11-08 13:01:45}, priority = {0}, title = {Evolution of adverse changes in stored RBCs}, url = {http://dx.doi.org/10.1073/pnas.0708160104}, volume = {104}, year = {2007} }

TY - JOUR ID - citeulike:1884709 L3 - citeulike-article-id:1884709 TI - Evolution of adverse changes in stored RBCs JF - Proceedings of the National Academy of Sciences VL - 104 IS - 43 SP - 17063 EP - 17068 N2 - Recent studies have underscored questions about the balance of risk and benefit of RBC transfusion. A better understanding of the nature and timing of molecular and functional changes in stored RBCs may provide strategies to improve the balance of benefit and risk of RBC transfusion. We analyzed changes occurring during RBC storage focusing on RBC deformability, RBC-dependent vasoregulatory function, and S-nitrosohemoglobin (SNO-Hb), through which hemoglobin (Hb) O2 desaturation is coupled to regional increases in blood flow in vivo (hypoxic vasodilation). Five hundred ml of blood from each of 15 healthy volunteers was processed into leukofiltered, additive solution 3-exposed RBCs and stored at 16{degrees}C according to AABB standards. Blood was subjected to 26 assays at 0, 3, 8, 24 and 96 h, and at 1, 2, 3, 4, and 6 weeks. RBC SNO-Hb decreased rapidly (1.2 x 104 at 3 h vs. 6.5 x 104 (fresh) mol S-nitrosothiol (SNO)/mol Hb tetramer (P = 0.032, mercuric-displaced photolysis-chemiluminescence assay), and remained low over the 42-day period. The decline was corroborated by using the carbon monoxide-saturated copper-cysteine assay [3.0 x 105 at 3 h vs. 9.0 x 105 (fresh) mol SNO/mol Hb]. In parallel, vasodilation by stored RBCs was significantly depressed. RBC deformability assayed at a physiological shear stress decreased gradually over the 42-day period (P < 0.001). Time courses vary for several storage-induced defects that might account for recent observations linking blood transfusion with adverse outcomes. Of clinical concern is that SNO levels, and their physiological correlate, RBC-dependent vasodilation, become depressed soon after collection, suggesting that even "fresh" blood may have developed adverse biological characteristics. 10.1073/pnas.0708160104 KW - nitric_oxide AU - Bennett-Guerrero, Elliott AU - Veldman, Tim AU - Doctor, Allan AU - Telen, Marilyn AU - Ortel, Thomas AU - Reid, Scott AU - Mulherin, Melissa AU - Zhu, Hongmei AU - Buck, Raymond AU - Califf, Robert AU - Mcmahon, Timothy PY - 2007/10/23/ UR - http://dx.doi.org/10.1073/pnas.0708160104 ER -