Rheological evaluation of X-ray irradiated blood

Blood unit segments accurately represent the biophysical properties of red blood cells in blood bags but not hemolysis

BACKGROUND

The biophysical properties of red blood cells (RBCs) provide potential biomarkers for the quality of donated blood. Blood unit segments provide a simple and nondestructive way to sample RBCs in clinical studies of transfusion efficacy, but it is not known whether RBCs sampled from segments accurately represent the biophysical properties of RBCs in blood bags.

STUDY DESIGN AND METHODS

RBCs were sampled from blood bags and segments every two weeks during 8 weeks of storage at 4°C. RBC deformability was measured by deformability-based sorting using the microfluidic ratchet device in order to derive a rigidity score. Standard hematological parameters, including mean corpuscular volume (MCV), red cell distribution width (RDW), mean cell hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and hemolysis were measured at the same time points.

RESULTS

Deformability of RBCs stored in blood bags was retained over 4 weeks storage, but a progressive loss of deformability was observed at weeks 6 and 8. This trend was mirrored in blood unit segments with a strong correlation to the blood bag data. Strong correlations were also observed between blood bag and segment for MCV, MCHC, and MCH but not for hemolysis.

CONCLUSION

RBCs sampled from blood unit segments accurately represent the biophysical properties of RBCs in blood bags but not hemolysis. Blood unit segments provide a simple and nondestructive sample for measuring RBC biophysical properties in clinical studies.

Blood banking-induced alteration of red blood cell flow properties

BACKGROUND

Blood banking procedures are associated with damage to red blood cell (RBC) membranes, which can impair their flow properties, namely, their deformability, aggregability, and adherence to endothelial cells (ECs) and thus possibly introducing a circulatory risk to recipients. This study was undertaken to comprehensively explore the effect of cold storage and gamma irradiation on RBC flow properties.

STUDY DESIGN AND METHODS

RBC flow properties were monitored as a function of shear stress with a computerized cell flow properties analyzer. Because we had previously studied storage effect on RBC aggregability (Transfusion 1999;39:277-81), here we determined the storage effect on RBC adherence and deformability, by measuring them before (control) and during storage. Gamma irradiation effect on RBC aggregability, adherence, and deformability was determined before (control) and after irradiation.

RESULTS

Cold storage significantly elevated the number of adherent RBCs and the strength of their interaction with ECs, and was marked by decreased RBC deformability as early as 2 weeks into the storage period. The elevation of RBC-EC interaction was well correlated with translocation of phosphatidylserine to the RBC surface. Gamma irradiation induced an immediate and marked increase in the number of rigid cells, but did not affect RBC adherence and aggregability.

CONCLUSION

RBC flow properties appear to be especially sensitive to cold storage and gamma irradiation because they are impaired long before the expiration date. Because impaired RBC flow properties facilitate circulatory disorders, the potential circulatory risk of transfusion RBC with blood banking-impaired rheology should be considered.

Elastic properties of irradiated RBCs measured by optical tweezers

BACKGROUND

Gamma irradiation of RBCs results in the production of reactive oxygen capable of initiating the process of membrane lipid peroxidation and accelerates the leakage of potassium ions from RBCs, resulting in an increase of internal viscosity.

STUDY DESIGN AND METHODS

The elastic properties of irradiated and stored RBC units were studied using laser optical tweezers. The laser trapped the cell and the membrane elasticity was analyzed, measuring the cell deformation in six different drag velocities. Five RBC units were split into two portions. One portion received a gamma irradiation dose of 25 Gy, and the second one was used as a control and was not irradiated. All units were stored (4 degrees C), and the elasticity was examined on Days 1, 14, 21, and 28.

RESULTS

Elastic properties (mu) from irradiated RBCs stored for 21 and 28 days were significantly affected compared with control cells (21 days: control, 0.3 +/- 0.03 x 10(-3); irradiated, 3.5 +/- 1.3 x 10(-3) dyn/cm; p < 0.001; and 28 days: control, 0.5 +/- 0.09 x 10(-3); irradiated, 14 +/- 3.2 x 10(-3) dyn/cm; p < 0.001).

CONCLUSION

The sensitivity of the laser optical tweezers method showed that there is no significant change in elasticity over time for up to 14 days of storage, regardless of whether the unit was irradiated or not. However, beyond 21 days of storage, irradiated units demonstrate decreased elasticity.

Blood irradiation for intraoperative autotransfusion in cancer surgery: demonstration of efficient elimination of contaminating tumor cells

BACKGROUND

Intraoperative blood salvage is contraindicated in cancer surgery because of contaminating tumor cells and the risk of systemic dissemination. On the basis of the radiosensitivity of cancer cells, irradiation of salvaged blood with 50 Gy is proposed as a way to allow return of salvaged blood.

STUDY DESIGN AND METHODS

Elimination of tumor cells by blood irradiation was studied in vitro with cells from 10 cell lines and from 14 tumor preparations after their addition to red cells in high numbers, or with blood shed during cancer surgery. Before and after gamma radiation, tumor cells were isolated by density gradient centrifugation and tested for their proliferative capacity in a cell colony assay. DNA metabolism was analyzed by incorporation of 5' bromodesoxyuridine.

RESULTS

Survival curves of cells from various tumors confirmed D0 (the dose required to reduce the fraction of surviving cells to 37 percent of the original value) values in the range of 1.2 to 2.2 Gy. After irradiation of tumor cell-contaminated blood with 50 Gy, no cell colony formation was observed, which indicates a reduction rate exceeding 10 log. Irradiated cancer cells showed viability, but no residual DNA metabolism.

CONCLUSION

The level of inactivation by a 50-Gy dose far exceeds that needed to inactivate the number of proliferating tumor cells observed or expected in wound blood. These results provide the experimental basis for the clinical application of blood irradiation for intraoperative blood salvage in cancer surgery.

Transfusion-associated graft-versus-host disease: current concepts and future trends

Since the initial reports, in the early 1960s, of Transfusion-Associated Graft-versus-Host Disease (TA-GVHD) in infants with congenital immunodeficiency and individuals with various haematological malignancies, our knowledge of this rare but uniformly fatal consequence of transfusion has improved. Today, it is possible to define with greater certainty patients who are most at risk; the blood components capable of causing TA-GVHD; and the methods for preventing TA-GVHD. In the absence of effective treatment for TA-GVHD, attention is currently focused on potential preventative measures, in particular using u.v.- or gamma-irradiated blood components. This overview deals with some general aspects of the current concepts and future trends in treatment of TA-GVHD.

Conductometric study of erythrocytes during centrifugation. II. Erythrocyte deformability

Erythrocyte deformability was studied by continuous reading of sediment conductance during centrifugation. The decrease in sediment conductivity during centrifugation reflects erythrocyte deformation in the pellet. The degree of erythrocyte deformation depends on the duration of centrifugation and the magnitude of centripetal acceleration. When constant centrifugal force is applied over an extended period of time, a gradual decrease in pellet conductivity occurs. Stepwise enhancement of centripetal acceleration during centrifugation induces a rapid increase in erythrocyte deformation. After centrifugation, the relaxation of erythrocyte deformation is observed. However, the relaxation and the recovery of cell shape are incomplete. The difference in compressibility of previously centrifuged and noncentrifuged cells demonstrates that centrifugation causes irreversible alteration in erythrocyte deformability. The results show that the time-dependent resistance of erythrocyte sediment during centrifugation may serve as a useful index for the kinetics of erythrocyte deformation.