Anaerobic storage of red blood cells in a novel additive solution improves in vivo recovery - PubMed (original) (raw)

Anaerobic storage of red blood cells in a novel additive solution improves in vivo recovery

Larry J Dumont et al. Transfusion. 2009 Mar.

Abstract

Background: In preliminary studies, anaerobic red blood cell (RBC) storage reduced oxidative damage and phosphatidylserine exposure while maintaining adenosine triphosphate levels. The purpose of this study was to compare the 24-hour recovery and life span of autologous RBCs stored 6 and 9 weeks using OFAS3 additive solution in an anaerobic environment, compared to control RBCs aerobically stored in AS-3 for 6 weeks.

Study design and methods: Eight subjects were entered into a randomized, crossover study. Whole blood was collected from each subject twice separated by 12 weeks or more into CP2D and leukoreduced. Controls were stored in AS-3. Test units in OFAS3 were oxygen depleted with argon then stored 9 weeks in an anaerobic chamber at 1 to 6 degrees C. At the end of each storage period, RBCs were labeled with (51)Cr and (99m)Tc and reinfused to the subject following standard methods to determine double-label recovery and life span. Hypotheses tests were conducted using paired, repeated-measures analysis of variance.

Results: Recovery for the anaerobically stored test RBC was significantly better than control at 6 weeks (p = 0.023). Test units at 9 weeks were not different than the 6-week control units (p = 0.73). Other in vitro measures of RBC characteristics followed the same trend. Two test units at 9 weeks had hemolysis of greater than 1 percent.

Conclusion: Anaerobically stored RBCs in OFAS3 have superior recovery at 6 weeks compared to the controls and equivalent recovery at 9 weeks with no change in life span. Anaerobic storage of RBCs may provide improved RBCs for transfusion at 6 weeks of storage and may enable extending storage beyond the current 42-day limit.

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Figures

Figure 1

Figure 1. Study design

Eight study subjects were randomly assigned to test or control study arms. A minimum of 56 days elapsed between RBC collections.

Figure 2

Figure 2. Hemolysis over storage

Percent hemolysis at the end of storage for aerobically stored RBC in AS3, and anaerobically stored in OFAS3 for 6 and 9 weeks from the same subject are shown. Four subjects (solid symbols) had distinctly higher hemolysis for all conditions.

Figure 3

Figure 3. 24 h Recovery (DLR) by subject

Control at 6 weeks, Test at 6 weeks and Test at 9 weeks. There is no difference demonstrated between Control 6 weeks and Test 9 weeks (p=0.41). Test at 6 weeks is superior to Control at 6 weeks (p=0.023).

Figure 4

Figure 4. Lifespan by subject

Control at 6 weeks, Test at 6 weeks and Test at 9 weeks. There is no difference between the 3 study arms (p=0.73).

Figure 5

Figure 5. RBC ATP content affects 24 hr RBC Recovery

ATP (μmol/g-Hb) content in the RBC on the day of study is shown against the 24 hr RBC in vivo recovery. AS-3 6-week (o), OFSA3 6-week (x), OFSA2 9-week (●)

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References

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