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Transfusion. 2018 Aug;58(8):1980-1991. doi: 10.1111/trf.14623. Epub 2018 Apr 24.

Metabolomics evaluation of early-storage red blood cell rejuvenation at 4°C and 37°C.

Author information

1
Department of Biochemistry and Molecular Genetics, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado.
2
Duke University School of Medicine, Durham, North Carolina.
3
Zimmer Biomet, Braintree, Massachusetts.
4
Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina.

Abstract

BACKGROUND:

Refrigerated red blood cell (RBC) storage results in the progressive accumulation of biochemical and morphological alterations collectively referred to as the storage lesion. Storage-induced metabolic alterations can be in part reversed by rejuvenation practices. However, rejuvenation requires an incubation step of RBCs for 1 hour at 37°C, limiting the practicality of providing "on-demand," rejuvenated RBCs. We tested the hypothesis that the addition of rejuvenation solution early in storage as an adjunct additive solution would prevent-in a time window consistent with the average age of units transfused to sickle cell recipients at Duke (15 days)-many of the adverse biochemical changes that can be reversed via standard rejuvenation, while obviating the incubation step.

STUDY DESIGN AND METHODS:

Metabolomics analyses were performed on cells and supernatants from AS-1 RBC units (n = 4), stored for 15 days. Units were split into pediatric bag aliquots and stored at 4°C. These were untreated controls, washed with or without rejuvenation, performed under either standard (37°C) or cold (4°C) conditions.

RESULTS:

All three treatments removed most metabolic storage by-products from RBC supernatants. However, only standard and cold rejuvenation provided significant metabolic benefits as judged by the reactivation of glycolysis and regeneration of adenosine triphosphate and 2,3-diphosphoglycerate. Improvements in energy metabolism also translated into increased capacity to restore the total glutathione pool and regenerate oxidized vitamin C in its reduced (ascorbate) form.

CONCLUSION:

Cold and standard rejuvenation of 15-day-old RBCs primes energy and redox metabolism of stored RBCs, while providing a logistic advantage for routine blood bank processing workflows.

PMID:
29687892
DOI:
10.1111/trf.14623
[Indexed for MEDLINE]

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