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Evolution of adverse changes in stored RBCs.

Publication ,  Journal Article
Bennett-Guerrero, E; Veldman, TH; Doctor, A; Telen, MJ; Ortel, TL; Reid, TS; Mulherin, MA; Zhu, H; Buck, RD; Califf, RM; McMahon, TJ
Published in: Proc Natl Acad Sci U S A
October 23, 2007

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) O(2) 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 1-6 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 10(-4) at 3 h vs. 6.5 x 10(-4) (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 10(-5) at 3 h vs. 9.0 x 10(-5) (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.

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Published In

Proc Natl Acad Sci U S A

DOI

ISSN

0027-8424

Publication Date

October 23, 2007

Volume

104

Issue

43

Start / End Page

17063 / 17068

Location

United States

Related Subject Headings

  • Vasodilation
  • Time Factors
  • Shear Strength
  • S-Nitrosothiols
  • Potassium
  • Phosphatidylserines
  • Oxygen
  • Lactic Acid
  • Hydrogen-Ion Concentration
  • Humans
 

Citation

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Bennett-Guerrero, E., Veldman, T. H., Doctor, A., Telen, M. J., Ortel, T. L., Reid, T. S., … McMahon, T. J. (2007). Evolution of adverse changes in stored RBCs. Proc Natl Acad Sci U S A, 104(43), 17063–17068. https://doi.org/10.1073/pnas.0708160104
Bennett-Guerrero, Elliott, Tim H. Veldman, Allan Doctor, Marilyn J. Telen, Thomas L. Ortel, T Scott Reid, Melissa A. Mulherin, et al. “Evolution of adverse changes in stored RBCs.Proc Natl Acad Sci U S A 104, no. 43 (October 23, 2007): 17063–68. https://doi.org/10.1073/pnas.0708160104.
Bennett-Guerrero E, Veldman TH, Doctor A, Telen MJ, Ortel TL, Reid TS, et al. Evolution of adverse changes in stored RBCs. Proc Natl Acad Sci U S A. 2007 Oct 23;104(43):17063–8.
Bennett-Guerrero, Elliott, et al. “Evolution of adverse changes in stored RBCs.Proc Natl Acad Sci U S A, vol. 104, no. 43, Oct. 2007, pp. 17063–68. Pubmed, doi:10.1073/pnas.0708160104.
Bennett-Guerrero E, Veldman TH, Doctor A, Telen MJ, Ortel TL, Reid TS, Mulherin MA, Zhu H, Buck RD, Califf RM, McMahon TJ. Evolution of adverse changes in stored RBCs. Proc Natl Acad Sci U S A. 2007 Oct 23;104(43):17063–17068.
Journal cover image

Published In

Proc Natl Acad Sci U S A

DOI

ISSN

0027-8424

Publication Date

October 23, 2007

Volume

104

Issue

43

Start / End Page

17063 / 17068

Location

United States

Related Subject Headings

  • Vasodilation
  • Time Factors
  • Shear Strength
  • S-Nitrosothiols
  • Potassium
  • Phosphatidylserines
  • Oxygen
  • Lactic Acid
  • Hydrogen-Ion Concentration
  • Humans