In vitro measures of membrane changes reveal differences between red blood cells stored in saline-adenine-glucose-mannitol and AS-1 additive solutions: a paired study.
Author(s): Sparrow RL, Sran A, Healey G, Veale MF, Norris PJ
Publication: Transfusion, 2014, Vol. 54, Page 560-8
PubMed ID: 23869602 PubMed Review Paper? No
Purpose of Paper
The purpose of this paper was to determine the effects of red blood cell (RBC) storage solution and refrigerated storage duration on markers of RBC quality and membrane changes including microparticle counts and interactions with endothelial cells.
Conclusion of Paper
Hemolysis, forward scatter, mean corpuscular volume (MCV) and microparticle counts increased and pH declined with refrigerated storage of RBCs. The mean corpuscular volume (MCV) was higher and Mean corpuscular hemoglobin (Hb) concentration (MCHC) was lower in RBCs in additive solution -1 (AS-1) than saline-adenine-glucose-mannitol (SAGM) Further, the increase in hemolysis and microparticle counts during refrigerated storage was lower in AS-1 RBCs than SAGM RBCs. Side scatter increased with refrigerated storage of RBCs in AS-1, but not SAGM. Further, adhesion of RBCs to endothelial cells during refrigerated storage was dependent on storage solution. pH and forward scatter were not affected by storage solution.
Studies
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Study Purpose
The purpose of this study was to determine the effects of RBC storage solution and refrigerated storage duration on markers of RBC quality and membrane changes including microparticle counts and interactions with endothelial cells. RBCs were prepared from leukoreduced whole blood processed within 2.7 h. Blood was pooled and divided before RBC processing.
Summary of Findings:
On day 1 of refrigerated storage, SAGM and AS-1 stored RBCs had comparable RBC counts, Hb, hemtocrit, hemolysis, and pH, but MCV was higher and MCHC was lower in AS-1 RBCs than SAGM RBCs. During refrigerated storage, pH declined similarly in SAGM and AS-1 RBCs (p<0.0001, both), but hemolysis increased more rapidly in SAGM RBCs than AS-1 RBCs, with significant differences apparent from day 14 onward (p<0.04). MCV rose during refrigerated storage of AS-1 and SAGM RBCs (p<0.001), but MCV was higher in AS-1 RBCs than SAGM RBCs through day 28 of refrigerated storage (p<0.01). Forward scatter increased during refrigerated storage, regardless of storage solution (p<0.006), indicating swelling of the RBCs. Side scatter increased with refrigerated storage of RBCs in AS-1 (p=0.001), but not SAGM, indicating an increase in irregular shaped RBCs during refrigerated storage in AS-1. Microparticle counts increased in the supernatant of RBCs during refrigerated storage, regardless of storage solution (p<0.001, both), but the supernatant of SAGM RBCs contained more glycophorin A (GPA) positive and annexin-V binding microparticles from day 1 onward than the supernatant of AS-1 RBCs (p<0.03), and the difference in microparticle counts between storage solutions increased with increasing refrigerated storage. Adhesion of RBCs to endothelial cells during continuous flow perfusion increased with increasing refrigerated storage duration in AS-1 (P<0.001) including a large increase between day 28 and 42 (p<0.03). RBCs in SAGM had higher endothelial adhesion on day 28 than RBCs in AS-1 (p=0.04) but after day 28, adhesion decreased in RBCs in SAGM such that it was lower than in RBCs in AS-1 on day 42 (p=0.025).
Biospecimens
Preservative Types
- Other Preservative
Diagnoses:
- Normal
Platform:
Analyte Technology Platform Small molecule pH Cell count/volume Flow cytometry Cell count/volume Hematology/ auto analyzer Cell count/volume Light microscopy Protein Spectrophotometry Morphology Flow cytometry Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Storage Storage duration 1 day
14 days
21 days
28 days
42 days
Storage Short-term storage solution AS-1
SAGM