目的:本研究旨在研究来自新鲜采集的献血者(F-RBC)和包装的红细胞(RBC)的可变形性的供者与供者之间的差异。
背景:按先进先出(FIFO)标准提供包装的红细胞用于输血,假设它们的质量对于具有相等存储持续时间的包装RBC是相同的。为了挑战这个概念,我们确定了F-RBC和包装的RBC储存不同持续时间的变形能力。
方法:采用三个RBC组:A.79个F-RBC样品;B.76个包装的RBC单元样品,随机用于不同储存持续时间的输血;和C.65个过期包装的红细胞样品储存35至37天。将所有包装的RBC单元非白细胞过滤并储存在具有腺嘌呤的柠檬酸盐-磷酸盐-葡萄糖溶液(CPDA-1)中。使用计算机化的细胞流动特性分析仪确定红细胞变形性,它监测在窄间隙流动室中直接可视化的细胞的形状变化,并提供大红细胞群体中的细胞变形性分布。
结果:F-RBC可变形性表现出广泛的供体间变异性。包装的红细胞的冷藏表现出变形性的轻度降低,这变得很重要,与最初的供体间变异性相比,仅在储存3周后。
结论:通常根据FIFO标准提供包装的红细胞用于输血,其假设是储存时间是红细胞质量的关键因素。这项研究表明,红细胞的变形能力在供体中是显著不同的,在整个储存过程中,大量的可变性仍然存在。因此,FIFO标准不足以评估红细胞变形性,应该,因此,为每个单元具体表征。
OBJECTIVE: This study aimed to examine the donor-to-donor variability in the deformability of red blood cells (RBCs) from freshly collected blood donations (F-RBC) and packed RBCs.
BACKGROUND: Packed RBCs are supplied for transfusion by the first-in-first-out (FIFO) criterion, assuming that their quality is the same for packed RBCs with equal storage duration. To challenge this notion, we determined the deformability of F-RBC and packed RBCs stored for different durations.
METHODS: Three RBC groups were employed: A. 79 samples of F-RBC; B. 76 samples of packed RBC units, randomly used for transfusion at different storage durations; and C. 65 samples of outdated packed RBCs stored for 35 to 37 days. All packed RBC units were non-leukofiltrated and stored in Citrate-phosphate-dextrose solution with adenine (CPDA-1). RBC deformability was determined using a computerised cell-flow properties analyser, which monitors the shape change of cells directly visualised in a narrow-gap flow chamber and provides the cells\' deformability distribution in a large RBC population.
RESULTS: The F-RBC deformability exhibited a wide-range inter-donor variability. The cold storage of packed RBCs exerted a mild reduction of deformability, which became significant, compared to the initial inter-donor variability, only after 3 weeks of storage.
CONCLUSIONS: Packed RBCs are generally supplied for transfusion by the FIFO criterion based on the assumption that the storage duration is a key factor of RBC quality. This study demonstrates that the deformability of red blood cells is significantly different in donors, and substantial variability persists throughout the entire process of their storage. Therefore, the FIFO criterion is not sufficient for assessing the RBC deformability, which should, therefore, be specifically characterised for each unit.