Premium
Microhemodynamic aberrations created by transfusion of stored blood
Author(s) -
Yalcin Ozlem,
Ortiz Daniel,
Tsai Amy G.,
Johnson Paul C.,
Cabrales Pedro
Publication year - 2014
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12361
Subject(s) - hematocrit , hemodynamics , cremaster muscle , intravital microscopy , microcirculation , blood cell , red blood cell , in vivo , exchange transfusion , blood flow , hemorheology , cell , chemistry , medicine , microbiology and biotechnology , immunology , biology , anesthesia , biochemistry
Background Human red blood cells ( RBCs ) can be stored for up to 42 days under controlled conditions. Physical and chemical changes occur during RBC storage, altering their function. This study links stored cell mechanical changes with hemodynamic functional alterations upon transfusion. Study Design and Methods Mechanical properties of fresh and stored RBCs were evaluated in vitro. Their transfusion effects were evaluated in vivo using intravital microscopy of the rat's cremaster muscle preparation. Rats were hemodiluted to 30% hematocrit, to mimic an anemic state before transfusion, and then exchange‐transfused with fresh or stored cells. Results In vitro studies on rheology and oxygen affinity of stored cells confirmed previously published results. Storage was found to modify static and dynamic RBC mechanic behavior. After transfusion, systemic hemodynamics were similar for fresh and stored cells; however, microvascular hemodynamics were drastically affected by stored cells. Stored cells reduced blood flow and oxygen delivery. Additionally, the presence of stored cells in circulation affected cell‐to‐cell and cell‐to‐wall interactions and affected cell hydrodynamics. Stored cells disrupted the RBC cell‐free layer and wall shear stress signals. Conclusion The reduced cell deformability due to RBC “storage lesions” caused pathologic changes in microvascular hemodynamics, endothelial cell mechanotransduction, and RBC dynamics. Thus, the mechanical changes of blood‐banked cells can limit transfusion ability to achieve its intended goal.