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Transfusion. 2014 Apr;54(4):1146-52. doi: 10.1111/trf.12370. Epub 2013 Aug 9.

Mannitol-adenine-phosphate: a novel solution for intraoperative blood salvage.

Author information

1
Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China; Department of Anesthesiology, Three Gorges Central Hospital of Chongqing, Chongqing, China.

Abstract

BACKGROUND:

Intraoperative blood salvage (IBS) procedures include washing with normal saline (NS), which may deplete red blood cell (RBC) nutrients. The mannitol-adenine-phosphate (MAP) solution, commonly used for RBC preservation, provides glycolytic substrates; therefore, MAP should be a better solution than NS in IBS. In this study, we determined whether using MAP could reduce washing-associated RBC damage and destruction.

STUDY DESIGN AND METHODS:

Adenine nucleotide contents, RBC morphology, and plasma free hemoglobin (PF-Hb) level of RBCs treated with NS or MAP solution were compared under three conditions: (1) 4-hour preservation of fresh blood from healthy volunteers, (2) collection from the shed blood of patients, and 3) incubation of the collected shed blood with plasma.

RESULTS:

Adenine nucleotide level and RBC elongation index were greater and PF-Hb level was lower in MAP groups than NS groups (p < 0.05) after preservation and incubation. In NS, RBCs lost their deformability and became stomatocytes, and even RBC "ghosts" 48 hours after incubation, while they remained normal in MAP solution.

CONCLUSION:

The MAP solution helps preserve RBC morphology and function, and reduces hemolysis, possibly due to improved energy production. Therefore, MAP should replace NS during IBS.

PMID:
23927791
DOI:
10.1111/trf.12370
[Indexed for MEDLINE]
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