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Stored red blood cell susceptibility to in vitro transfusion‐associated stress conditions is higher after longer storage and increased by storage in saline‐adenine‐glucose‐mannitol compared to AS‐1
Author(s) -
Mittag Diana,
Sran Amrita,
Chan Kasey S.,
Boland Martin P.,
BandalaSanchez Esther,
Huet Olivier,
Xu William,
Sparrow Rosemary L.
Publication year - 2015
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.13138
Subject(s) - mannitol , in vitro , saline , blood preservation , red cell , red blood cell , chemistry , medicine , andrology , biochemistry , endocrinology
BACKGROUND Biochemical changes induced in red blood cells (RBCs) during storage may impair their function upon transfusion. Transfusion‐associated stresses may further amplify storage lesion effects including increased phosphatidylserine (PS) exposure at the RBC membrane, microparticle (MP) release, and adhesion to endothelial cells (ECs). RBC stress susceptibility in vitro was investigated in relation to storage time and additive solution. STUDY DESIGN AND METHODS Leukoreduced whole blood donations (n = 18) were paired, mixed, and resplit before separating the RBCs for storage in saline‐adenine‐glucose‐mannitol (SAGM) or AS‐1. Samples were taken after 3, 21, or 35 days. For oxidative stress treatment, RBCs were exposed to 0.5 mmol/L tert‐butylhydroperoxide. Transfusion‐associated stress was simulated by overnight culture at 37 °C with plasma containing inflammatory mediators. PS exposure and MPs were measured by flow cytometry and adhesion to ECs was tested under flow conditions. PS specificity of adhesion was tested by blocking with PS‐containing lipid vesicles. RESULTS Oxidative stress induced significantly higher PS exposure and adhesion to ECs in RBCs stored for 35 days compared to 3 days (p < 0.04). PS‐containing vesicles blocked RBC‐EC adhesion. After overnight culture with or without plasma, PS exposure and EC adhesion were significantly increased (p < 0.05). MP numbers increased with longer RBC storage and after RBC culture with plasma. Culture conditions influenced MP numbers from Day 35 RBCs. RBCs stored in SAGM had significantly higher PS exposure after stress treatment than AS‐1 RBCs (p < 0.02). CONCLUSION Storage for 35 days significantly increased RBC susceptibility to oxidative and in vitro transfusion‐associated stresses and was higher for RBCs stored in SAGM compared to AS‐1.