Storage of red blood cells with improved maintenance of 2,3-bisphosphoglycerate
Storage of red blood cells with improved maintenance of 2,3-bisphosphoglycerate
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DOI：
10.1111/j.1537-2995.2006.00893.x
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发表时间：
2006-09-01
期刊：
影响因子：
2.9
通讯作者：
Meryman, Harold T.
中科院分区：
文献类型：
--
作者：
Hogman, Claes F.;Lof, Helena;Meryman, Harold T.
背景技术背景：在储存过程中，红细胞（RBC）迅速失去2，3-二磷酸甘油酸（2，3-DPG），导致对O-2的亲和力增加，O-2转运暂时受损。最近的临床评估表明，输血红细胞的质量可能是更重要的患者生存比以前recognized.Study设计和方法：无葡萄糖添加剂的解决方案（AS）与柠檬酸钠，葡萄糖酸钠，腺嘌呤，甘露醇，磷酸盐在高pH值，溶液，可以热灭菌。使用CP 2D作为抗凝剂。向AS中添加额外的CP 2D以供应葡萄糖。将RBC储存在4 ℃下，并定期测定细胞内pH（pHi）、细胞外pH、葡萄糖、乳酸盐、磷酸盐、ATP、2，3-DPG、溶血和形态。在血细胞比容（Hct）水平为59%至60%的175 mL无氯低渗培养基中储存导致pHi升高并维持2，3-DPG等于或高于初始值持续2周，而没有ATP损失。加入400 mL储存溶液，然后离心并除去300 mL过量溶液至60%至66%的Hct水平，进一步降低了氯化物浓度，导致2，3-DPG维持4周。溶血是在0.1%，在6 weeks.CONCLUSION：在维护2，3-DPG的改善实现了与175毫升的无氯化物的存储溶液与熟悉的添加剂在无毒浓度，以增加pH值。相反，加入400 mL储存溶液，然后除去300 mL，降低了氯化物浓度，增加了pHi，并将2，3-DPG的维持时间延长至4周。
BACKGROUND: During storage, red blood cells (RBCs) rapidly lose 2,3-bisphosphoglycerate (2,3-DPG) leading to an increase in the affinity for O-2 and a temporary impairment of O-2 transport. Recent clinical evaluations indicate that the quality of transfused RBCs may be more important for patient survival than previously recognized.STUDY DESIGN AND METHODS: Glucose-free additive solutions (ASs) were prepared with sodium citrate, sodium gluconate, adenine, mannitol, and phosphates at high pH, a solution that can be heat-sterilized. CP2D was used as an anticoagulant. Additional CP2D was added to the AS to supply glucose. RBCs were stored at 4 degrees C and assayed periodically for intracellular pH (pHi), extracellular pH, glucose, lactate, phosphate, ATP, 2,3-DPG, hemolysis, and morphology.RESULTS: Storage in 175 mL of the chloride-free, hypotonic medium at a hematocrit (Hct) level of 59 to 60 percent resulted in an elevated pHi and the maintenance of 2,3-DPG at or above the initial value for 2 weeks without loss of ATP. The addition of 400 mL of storage solution followed by centrifugation and removal of 300 mL of excess solution to a Hct level of 60 to 66 percent further reduced the chloride concentration, resulting in the maintenance of 2,3-DPG for 4 weeks. Hemolysis was at 0.1 percent at 6 weeks.CONCLUSION: Improvements in the maintenance of 2,3-DPG were achieved with 175 mL of a chloride-free storage solution with familiar additives at nontoxic concentrations to increase pHi. Adding, instead, 400 mL of storage solution followed by the removal of 300 mL reduced the chloride concentration, increasing the pHi and extending the maintenance of 2,3-DPG to 4 weeks.