Effects Of Replacing Additive Solution On The Storage Of Red Blood Cells At Different Time Points And Frequency

Part 1.Effects of replacing additive solution at different storage time pointsObjectiveTo evaluate the effect of replacing additive solution at different storage time points.Method30 donors were collected after physical examination,and whole blood was collected according to donation process.After suspension red blood cells were prepared according to standard,RBCs were divided into replacement group 1(replace additive solution at 14days after storage),replacement group 2(replace additive solution at 28 days after storage),and control group,10 cases in each group.All groups were sampled for3,7,14,21,28 and35 days.Routine blood test,Na~+,K~+,glucose,lactic,phosphatidylserine exposure and morphology were tested to evaluate the effect of replacing additive solution at different storage time points.ResultFor 3-35 days,concentration of Na~+of control group decreased from(114.1±6.17)mmol/L to(80.3±6.46)mmol/L,and concentration of K~+increased from(6.97±1.38)mmol/L to(35.17±8.61)mmol/L,and concentration of glucose decreased from(28.06±2.77)mmol/L to(16.19±4.11)mmol/L;and concentration of lactate increased from(3.44±6.46)mmol/L to(10.74±0.12)mmol/L.In replacement group 1,after replacing additive solution,concentration of Na~+and glucose were higher than those of control group(p<0.05),and concentration of K~+and lactate were lower than those of control group(p<0.05).In replacement group 2,after replacing additive solution,concentration of Na~+and glucose were higher than those of control group(p<0.05),and concentration of K~+and lactate were lower than those of control group(p<0.05).After 35 days of storage,concentration of lactate in replacement group 2 was lower than that of replacement group 1(p<0.05),and there was no significant difference between concentration of Na~+,K~+and glucose(p>0.05).There was no significant difference in PS positive rate,echinocytes rate and MCV between replacement group 1,replacement group 2 and control group for 3-35days(p>0.05).ConclusionReplacement of additive solution(SAGM,pH5.1)during storage of red blood cells can improve storage environment in distribution of ions,supplement glucose,remove lactate and other metabolites,recovery of glycolysis,and will not affect PS exposure,echinocytes rate and MCV.It is a better choice to replace additive solution at 14 days after storage as correction of ion imbalances and recovery of glycolysis.Part 2.Effects of replacing additive solution 14 days after storageObjectiveTo evaluate the effect of replacing additive solution at 14 days after storage from oxidative stress,hemolysis,osmotic fragility and other aspects.Method10 donors were collected after physical examination,and whole blood was collected according to donation process.After suspension red blood cells were prepared according to standard,RBCs were divided into two copies,replacement group(replace additive solution at 14 days after storage),and control group,10 cases in each group.All groups were sampled for3,7,14,21,28 and 35 days.Routine blood test,Na~+,K~+,glucose,lactate,PS exposure rate,osmotic fragility,hemolysis rate,free hemoglobin,LPO and GSH were tested to evaluate the effect of replacing additive solution at 14 days after storage.ResultFor 3-35 days,concentration of Na~+in control group decreased from(115.4±3.34)mmol/L to(89.4±3.72)mmol/L,and K~+increased from(6.62±0.85)mmol/L to(31.67±2.85)mmol/L,and glucose decreased from(28.76±0.81)mmol/L to(18.66±1.16)mmol/L,and lactate increased from(3.44±3.72)mmol/L to(9.59±0.07)mmol/L;hemolysis rate increased from(0.08±0.03)%to(0.20±0.08)%;and pH decreased from7.23±0.07 to 6.94±0.07.For 3-14 days,LPO of control group decreased from(7.99±5.14)μmol/L to(3.43±0.74)μmol/L and increased to(4.98±1.38)μmol/L for 14-35 days.After replacing additive solution,concentration of K~+,lactate,hemolysis rate,LPO and pH in replacement group were lower than those of control group(p<0.05),and concentration of glucose was higher than that of control group(p<0.05).There was no significant difference in Na~+,PS positive rate,MCV,osmotic fragility and GSH between replacement group and control group(p>0.05).ConclusionReplacement of additive solution(SAGM,pH5.1)at 14 days after storage can relief imbalance of ions,reduce accumulation of lactate,depress oxidative stress,cut down hemolysis rate of red blood cell storage lesion.Part 3.Effects of replacing additive solution at every 14 days during storageObjectiveTo evaluate the effect of replacing additive solution at every 14 days during storage.Method10 donors were collected after physical examination,and whole blood was collected according to donation process.Suspension red blood cells were prepared according to standard.RBCs were sampled for3,14,28,42,56,70 and 84 days.Routine blood test,Na~+,K~+,glucose,lactate,PS exposure,osmotic fragility,hemolysis rate,free hemoglobin,LPO and GSH were tested to evaluate the effect of replacing additive solution at every 14 days.ResultFor 3-84 days,concentration of Na~+in supernatant decreased from(114.1±6.17)mmol/L to(88.4±5.89)mmol/L(p<0.05),and K~+increased from(6.97±1.38)mmol/L to(20.09±3.40)mmol/L at 14 days,and then decreased to(2.99±6.17)mmol/L(p<0.05),glucose decreased from(28.06±2.77)mmol/L to(25.55±1.10)mmol/L at 14 days,then increased to(39.59±1.48)mmol/L at 56 days,and then dropped to(35.91±2.69)mmol/L at84 days(p<0.05),lactate increased from(3.44±0.46)mmol/L to(8.99±0.41)mmol/L at 14days,then descended to(0.46±0.06)mmol/L at 84 days(p<0.05),positive rate of PS increased from(0.31±0.30)%to(3.07±1.39)%,and then dropped to(0.40±0.21)%at 56days,and then increased to(2.33±1.15)%at 84 days(p<0.05),MCV decreased from(91.51±2.33)fL to(87.86±2.63)fL,and then increased to(94.95±2.34)fL(p<0.05),osmotic fragility increased from(4.16±0.25)NaCl g/L to(5.08±0.19)NaCl g/L,and then decreased to(4.05±0.19)NaCl g/L(p<0.05).The hemolysis rate increased from(0.15±0.06)%to(0.97±0.24)%(p<0.05),and LPO decreased from(9.17±5.98)μmol/L to(2.36±0.47)μmol/L,and then increased to(5.40±1.17)μmol/L(p<0.05),and pH decreased from 7.22±0.08 to 6.18±0.04(p<0.05).ConclusionContinuously(every 14 days)replacing additive solution(SAGM,pH5.1),hemolysis rate exceeded the national standard after 5 times of replacement and increased storage lesion after 3 times of replacement.