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Rejuvenation solution as an adjunct cold storage solution maintains physiological haemoglobin oxygen affinity during early-storage period of red blood cells.

Publication ,  Journal Article
Evans, BA; Ansari, AK; Srinivasan, AJ; Kamyszek, RW; Stoner, KC; Fuller, M; Poisson, JL; Welsby, IJ
Published in: Vox Sang
July 2020

BACKGROUND: Red blood cell (RBC) units accumulate morphologic and metabolic lesions during storage before transfusion. Pyruvate-inosine-phosphate-adenine (PIPA) solutions (Rejuvesol, Biomet, Warsaw, IN) can be incubated with RBC units to mitigate storage lesions. This study proposes a PIPA treatment process, termed cold 'rejuvenation', using Rejuvesol as an adjunct additive solution, to prevent biomechanical storage lesions while avoiding the 1 h PIPA incubation required with standard PIPA treatment. We compared the efficacy of cold to standard 'rejuvenation' in improving metabolic lesions that occur during cold storage of RBCs, without altering function. METHODS: Twelve leucoreduced, A-positive RBC units were obtained. Each unit was aliquoted into either control (standard storage), washed (W), standard rejuvenation (SR) or cold rejuvenation (CR) groups, the latter two requiring washing. A volume-adjusted dose of Rejuvesol was instilled into the CR group upon receipt (Day 3). After 15 days of storage, p50, RBC deformability, in-bag haemolysis and mechanical fragility were analysed. 'Any treatment' is defined as W, SR and CR, with comparisons in reference to control. RESULTS: Higher p50s were seen in rejuvenated groups (>30 mmHg vs. <19 mmHg; P < 0·0001). Any treatment significantly increased elongation index (P = 0·034) but did not significantly increase in-bag haemolysis (P = 0·062). Mechanical fragility was not significantly different between groups (P = 0·055) at baseline, but the control (CTL) group was more fragile after 2 h in a cardiac bypass simulation than any treatment (P < 0·0001). CONCLUSIONS: This study demonstrates that rejuvenation (standard or cold) prevents the leftward p50 shift of storage lesions without detrimental effect on RBC deformity, in-bag haemolysis or mechanical fragility.

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Published In

Vox Sang

DOI

EISSN

1423-0410

Publication Date

July 2020

Volume

115

Issue

5

Start / End Page

388 / 394

Location

England

Related Subject Headings

  • Solutions
  • Pyruvic Acid
  • Oxygen
  • Inosine
  • Humans
  • Hemolysis
  • Hemoglobins
  • Erythrocytes
  • Cold Temperature
  • Cardiovascular System & Hematology
 

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Evans, B. A., Ansari, A. K., Srinivasan, A. J., Kamyszek, R. W., Stoner, K. C., Fuller, M., … Welsby, I. J. (2020). Rejuvenation solution as an adjunct cold storage solution maintains physiological haemoglobin oxygen affinity during early-storage period of red blood cells. Vox Sang, 115(5), 388–394. https://doi.org/10.1111/vox.12910
Evans, Brooke A., Andrea K. Ansari, Amudan J. Srinivasan, Reed W. Kamyszek, Keaton C. Stoner, Matthew Fuller, Jessica L. Poisson, and Ian J. Welsby. “Rejuvenation solution as an adjunct cold storage solution maintains physiological haemoglobin oxygen affinity during early-storage period of red blood cells.Vox Sang 115, no. 5 (July 2020): 388–94. https://doi.org/10.1111/vox.12910.
Evans BA, Ansari AK, Srinivasan AJ, Kamyszek RW, Stoner KC, Fuller M, et al. Rejuvenation solution as an adjunct cold storage solution maintains physiological haemoglobin oxygen affinity during early-storage period of red blood cells. Vox Sang. 2020 Jul;115(5):388–94.
Evans, Brooke A., et al. “Rejuvenation solution as an adjunct cold storage solution maintains physiological haemoglobin oxygen affinity during early-storage period of red blood cells.Vox Sang, vol. 115, no. 5, July 2020, pp. 388–94. Pubmed, doi:10.1111/vox.12910.
Evans BA, Ansari AK, Srinivasan AJ, Kamyszek RW, Stoner KC, Fuller M, Poisson JL, Welsby IJ. Rejuvenation solution as an adjunct cold storage solution maintains physiological haemoglobin oxygen affinity during early-storage period of red blood cells. Vox Sang. 2020 Jul;115(5):388–394.
Journal cover image

Published In

Vox Sang

DOI

EISSN

1423-0410

Publication Date

July 2020

Volume

115

Issue

5

Start / End Page

388 / 394

Location

England

Related Subject Headings

  • Solutions
  • Pyruvic Acid
  • Oxygen
  • Inosine
  • Humans
  • Hemolysis
  • Hemoglobins
  • Erythrocytes
  • Cold Temperature
  • Cardiovascular System & Hematology