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Haematology International Journal Research Article 4 min read

Serial Assessment of Biochemical Parameters of Red Cell in the Blood Unit Segments Kept At 4

Deva Japa A*, Mahpaekar M and Sanjeeth P
* Corresponding author
ISSN: 2578-501X  10.23880/hij-16000149  Received: November 14, 2019  Published: November 29, 2019
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 6 references
 2 figures
 2 tables
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Keywords
Red Blood Cell Storage Lesion Membrane Deformability
Abstract

The development of blood storage systems allowed donation and transfusion to be separated in time and space. This separation has permitted the regionalization of donor services with subsequent economies of scale and improvements in the quality and availability of blood products. However, the availability of storage raises the question of how long blood products can and should be stored and how long they are safe and effective. During blood bank cold storage, red cells progressively lose deformability and elasticity due to irreversible changes in the cell membrane. Aim: The aim of this study is to assess the relative importance of these diverse biochemical changes in the stored RBC. Methodology: The donors of the blood units included in this study were healthy by all parameters considered for blood banking. Whole blood of 450ml collection bag unit containing 63ml CPD/SAGM (which has a permissible life span of 42 days) and containing 63 ml of CPDA (which has a life span of 35 days) were subjected to standard component separation. A total of 35 consecutively separated blood bags with 7 segments each were studied. Each segment from the Packed Red Cell unit was removed on days 0, 7, 14, 21, 28, 35 and 42 of PRBC storage, were investigated. The biochemical and hematological parameters such as pH, Lactate, Sr.Potassium, Plasma Haemoglobin, Heamoglobin and Heamatocrit were analyzed in fully automated analyzer. Results and Analysis: RBC unit characteristics just before storage on Day 0 pH (37°C) 7.03+_0.94 (7.20-6.79) Hb (mg/dL) 15.3 +_2.2 (17.9-13.9),Plasma Hemoglobin 3.1+-1.2 gm/dl Lactate (mmol/L) 2 +_ 1.4 (1.3-3.1)Potassium(K) (mmol/L)1.7+-1.2. Extracellular K and Lactate showed a constant increase as the bags aged. Hemoglobin and Haematocrit levels did not change appreciably throughout the storage period. Conclusion: The older RBC may have adverse effects like increase in potassium, lactate but the transfusion department can help the clinician by knowing the patient’s clinical status as well as the age, critical variables like Sepsis by issuing the recent dated Blood units.

Deva Japa A*, Mahpaekar M and Sanjeeth P

Senior Research Scientist, DDMM Heart Institute, India

DDMM Heart Institute, Mission Road, Nadiad-387002, India, Tel: 91-9426562802;

Email: devajapa@ddmmheart.org

progressively lose deformability and elasticity due to irreversible changes in the cell membrane.

analyzed in fully automated analyzer.

levels did not change appreciably throughout the storage period.

recent dated Blood units.

Keywords: Red Blood Cell; Storage Lesion; Membrane Deformability

Serial Assessment of Biochemical Parameters of Red Cell in the Blood Unit Segments Kept At 40 Haematol Int J

Abbreviations: RBC: Red Blood Cells.

Introduction

The development of blood storage systems allowed donation and transfusion to be separated in time and space. This separation has permitted the regionalization of donor services with subsequent economies of scale and improvements in the quality and availability of blood products. However, the availability of storage raises the question of how long blood products can and should be stored and how long they are safe and effective. During blood bank cold storage, red cells progressively lose deformability and elasticity due to irreversible changes in the cell membrane. Morphologically this is observed as progressive irreversible formation of sphero-echinocytes. Due to the gradual decomposition of RBCs and as a result of the accumulation of products of cellular metabolism, i.e. anaerobic glycolysis, the biochemical composition of RBC concentrates changes. Although it is not clear to what extent anaerobic storage prevents morphological or biochemical changes. During refrigerated storage, RBCs become progressively damaged by storage lesions. Clinical implications collectively known as the RBC storage lesion, is in part related to bioreactive substances released by leucocytes in the storage medium, such as histamine, lipids, and cytokines, which may exert direct effects on recipients [1], presumably due to structural or functional changes in red blood cells (RBC) that occur during storage [2]. We have very scarce study to assess the relative importance of these diverse biochemical changes in the stored RBC. Due to the gradual decomposition of RBCs and as a result of the accumulation of products of cellular metabolism, the biochemical composition of RBC concentrates undergoes changes [3]. Although it is not clear to what extent, the anaerobic storage prevents morphological or biochemical changes at low temperature.

Methodology

The donors of the blood units included in this study were healthy by all parameters considered for blood banking. Whole blood of 450ml collection bag unit containing 63ml CPD/SAGM (which has a permissible life span of 42 days) and containing 63 ml of CPDA (which has a life span of 35 days) were subjected to standard component separation. A total of 35 consecutively separated blood bags with 7 segments each were studied. Each segment from the Packed Red Cell unit was removed on days 0, 7, 14, 21, 28, 35 and 42 of PRBC storage, were investigated. The biochemical and hematological parameters such as pH, Lactate, Sr.Potassium, Plasma Haemoglobin, Heamoglobin and Heamatocrit were analyzed in fully automated analyzer [4, 5, 6].

Results and Analysis

RBC unit characteristics just before storage on Day 0 pH (37°C) 7.03+0.94 (7.20-6.79) Hb (mg/dL) 15.3 +_2.2 (17.9-13.9),Plasma Hemoglobin 3.1+-1.2 gm/dl Lactate (mmol/L) 2 + 1.4 (1.3-3.1)Potassium(K) (mmol/L)1.7+- 1.2 (Tables 1 & 2 & Figures 1 & 2).

Mean
Biochemical factorsF valueP value
7th day14th day21st day28th day35th day42nd day
Plasma Hb3.133.263.263.43.783.953.622.060.06
Haemoglobin12.8511.7311.091110.0910.479.7812.780
Haematocrit38.9135.7433.7433.2930.8631.7429.612.730

Table 1: Biochemical Factors.

pH0 day7th day14th day21st day28th day35th day42nd day
Normal0000000
Abnormal37373737373637
Lactate0 day7th day14th day21st day28th day35th day42nd day
Normal28000000
Abnormal9373737373637
Serum K0 day7th day14th day21st day28th day35th day42nd day
Normal1000000
Abnormal36373737373637

Table 2: Extracellular K and Lactate showed a constant increase as the bags aged. Hemoglobin and Haematocrit levels did not chang

Figure 1: Hematological Parameters analysis in different duration.
Click to enlarge
Figure 1: Hematological Parameters analysis in different duration.
Figure 2: Biochemical analysis in stored RBC at different duration.
Click to enlarge
Figure 2: Biochemical analysis in stored RBC at different duration.

Conclusion

Clinical implications collectively known as the RBC storage lesion released by leucocytes in the storage medium, such as lactate, histamine, lipids and cytokines, which may exert direct effects on recipients, presumably due to structural or functional changes in RBC that occur during storage. But this study suggests that older RBC may have adverse effects like increase in potassium, lactate but the transfusion department can help the clinician by knowing the patient’s clinical status as well as the age, critical variables like Sepsis by issuing the recent dated Blood units.

References

  1. Wagner G, Chiu D, Qju J, Heath RH, Lubin BH (1987) Spectrin oxidation correlates with membrane vesiculation in stored RBCs. Blood 69(6): 1777-1781.
  2. D'Alessandro A, D'Amici G, Vaglio S, Zolla L (2012) Timecourse investigation of SAGM-stored leukocytefiltered erthrocyte concentrates: from metabolism to proteomics. Haematologica 97(1): 107-115.
  3. Koch C, Li L, Sessler D, Figueroa P, Hoeltge GA, et al. (2008) Duration of red-cell storage and complications after cardiac surgery. N Engl J Med 358: 1229-1239.
  4. Dzik W (2008) Fresh blood for everyone? Balancing availability and quality of stored RBCs. Transfus Med 18(4): 260-265.
  5. Hebert PC, Chin-Yee I, Fergusson D, Blajchman M, Martineau R, et al. (2005) A pilot trial evaluating the clinical effects of prolonged storage of red cells. Anesth Analg 100(5): 1433-1438.
  6. Hess JR, Hill HR, Oliver CK, Lippert LE, Rugg N, et al. (2003) Twelve-week RBC storage. Transfusion 43(7): 867-872.
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@article{deva2019,
  title   = {Serial Assessment of Biochemical Parameters of Red Cell in the
Blood Unit Segments Kept At 4},
  author  = {Deva Japa A, Mahpaekar M and Sanjeeth P},
  journal = {Haematology International Journal},
  year    = {2019},
  volume  = {3},
  number  = {2},
  doi     = {10.23880/hij-16000149}
}
Deva Japa A, Mahpaekar M and Sanjeeth P (2019). Serial Assessment of Biochemical Parameters of Red Cell in the
Blood Unit Segments Kept At 4. Haematology International Journal, 3(2). https://doi.org/10.23880/hij-16000149
TY  - JOUR
TI  - Serial Assessment of Biochemical Parameters of Red Cell in the
Blood Unit Segments Kept At 4
AU  - Deva Japa A, Mahpaekar M and Sanjeeth P
JO  - Haematology International Journal
PY  - 2019
VL  - 3
IS  - 2
DO  - 10.23880/hij-16000149
ER  -