Rejuvenation of ATP during storage does not reverse effects of the hypothermic storage lesion.
Author(s): Tchir JD, Acker JP, Holovati JL
Publication: Transfusion, 2013, Vol. 53, Page 3184-91
PubMed ID: 23581461 PubMed Review Paper? No
Purpose of Paper
The purpose of this paper was to determine the effects of refrigerated storage of red blood cells (RBCs) before and after treatment with cold rejuvenation solution or phosphate buffered saline (PBS) on markers of RBC quality.
Conclusion of Paper
During refrigerated storage of RBCs, significant changes were observed in hemolysis rates, morphology scores, mean corpuscular volume (MCV)(after 6 weeks), mean corpuscular hemoglobin (MCH)(after 6 weeks), pH, glucose concentration, and supernatant potassium levels. The addition of cold rejuvenation solution to RBCs increased ATP content and partially attenuated the storage-related increase in hemolysis rates and the decrease in morphology scores. However, other changes were not affected by this treatment.
Studies
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Study Purpose
The purpose of this study was to determine the effects of refrigerated storage of RBCs before and after treatment with cold rejuvenation solution or PBS on the markers of RBC quality. Packed RBCs in saline-adenine-glucose-mannitol (SAGM) were stored at room temperature for less than 24 h before refrigerated storage. On day 28, 35 or 42, matched specimens were treated with cold rejuvenation solution or PBS through a syringe or left untreated. After treatment specimens were incubated at 1-6 degrees C for 1 h and tested immediately and then weekly until day 49.
Summary of Findings:
During refrigerated storage of RBCs, hemolysis increased in all treatment groups (p<0.01), but the increase was partially attenuated by the addition of cold rejuvenation solution (p<0.01). Treatment of RBCs with cold rejuvenation solution increased ATP content compared to untreated or PBS-treated specimens (p<0.01, both), and the increase was maintained until day 49. The EImax did not change during refrigerated storage of untreated specimens, but it was transiently decreased at day 35 after treatment with rejuvenation solution on day 28(p<0.01) but was not affected by treatment on day 35 or 42. Morphology scores declined with increasing refrigerated storage of RBCs (p<0.01), but they were higher in rejuvenation-treated specimens than untreated or PBS-treated specimens (p<0.01, both). MCV and MCH remained within the reference range through day 35 of refrigerated storage, regardless of treatment, but by day 42, most specimens fell below the reference range. The pH and glucose concentration declined (p<0.01, both) and supernatant potassium increased during refrigerated storage (p<0.01), regardless of treatment. The KEI was not affected by refrigerated storage or treatment with rejuvenation solution. No differences between untreated and PBS-treated specimens were observed.
Biospecimens
Preservative Types
- Other Preservative
Diagnoses:
- Not specified
Platform:
Analyte Technology Platform Carbohydrate Clinical chemistry/auto analyzer Cell count/volume Spectrophotometry Electrolyte/Metal Ion selective electrode Gas Clinical chemistry/auto analyzer Morphology Hematology/ auto analyzer Morphology Light microscopy Small molecule Spectrophotometry Small molecule Clinical chemistry/auto analyzer Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Storage Storage duration 2 days
28 days
35 days
42 days
49 days
Biospecimen Aliquots and Components Biospecimen components Untreated
Cold PBS-treated
Cold rejuvenation solution-treated