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Is Fresh Blood Really Necessary: What is the latest?

Is Fresh Blood Really Necessary: What is the latest?. Darrell J. Triulzi MD Director Division of Transfusion Medicine University of Pittsburgh Medical Director Institute for Transfusion Medicine. What is the RBC storage lesion?.

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Is Fresh Blood Really Necessary: What is the latest?

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  1. Is Fresh Blood Really Necessary:What is the latest? Darrell J. Triulzi MD Director Division of Transfusion Medicine University of Pittsburgh Medical Director Institute for Transfusion Medicine

  2. What is the RBC storage lesion? As RBCs are stored ex vivo they undergo a series of biochemical, metabolic, structural, inflammatory and physiologic changes.

  3. Decrease in 2,3-DPG • 2,3-DPG is depleted during storage by day 14 • Its decline is mirrored by an increase in Hb oxygen saturation as hemoglobin affinity for O2 increases • 2,3-DPG is restored 24-72 hours after transfusion Bennett-Guerrero et al. PNAS, 2007

  4. RBC shape change • Stored RBCs undergo shape changes • Normal morphology is maintained until severe drops in intracellular ATP occur Red Cell Shape, Bessis M, Weed RI, Leblond PF, 1973

  5. As the RBCs change from discoid to sphere shapes their biomechanical properties change Relevy et al. Transfusion, 2007

  6. Nitric Oxide • The heme chain of oxygenated Hb binds NO species • Under hypoxic conditions the oxygen and NO species are released • NO causes vasodilatation increasing blood flow to hypoxic areas STORAGE LESION RBC microparticles accumulate during storage Donadee et al Circulation -2011;124:465-476.

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