Shape matters: the effect of red blood cell shape on perfusion of an artificial microvascular network

Abstract

BACKGROUND The shape of human red blood cells (RBCs) deteriorates progressively throughout hypothermic storage, with echinocytosis being the most prevalent pathway of this morphological lesion. As a result, each unit of stored blood contains a heterogeneous mixture of cells in various stages of echinocytosis and normal discocytes. Here we studied how the change in shape of RBCs following along the path of the echinocytic transformation affects perfusion of an artificial microvascular network (AMVN).

STUDY DESIGN AND METHODS Blood samples were obtained from healthy consenting volunteers. RBCs were leukocyte-reduced, re-suspended in saline, and treated with various concentrations of sodium salicylate to induce shape changes approximating the stages of echinocytosis experienced by RBCs during hypothermic storage (e.g. discocyte, echinocyte I, echinocyte II, echinocyte III, sphero-echinocyte and spherocyte). The AMVN perfusion rate was measured for 40% hematocrit suspensions of RBCs with different shapes.

RESULTS The AMVN perfusion rates for RBCs with discocyte and echinocyte I shapes were similar, but there was a statistically significant decline in the AMVN perfusion rate between RBCs with shapes approximating each subsequent stage of echinocytosis. The difference in AMVN perfusion between discocytes and spherocytes (the last stage of the echinocytic transformation) was 34%.

CONCLUSION The change in shape of RBCs from normal discocytes progressively through various stages of echinocytosis to spherocytes produced a substantial decline in the ability of these cells to perfuse an artificial microvascular network. Echinocytosis induced by hypothermic storage could therefore be responsible for a similarly substantial impairment of deformability previously observed for stored RBCs.

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Citation

Copyright 2017 Transfusion. This is a post-print version of a published paper that is available at: https://onlinelibrary.wiley.com/doi/full/10.1111/trf.13449 Recommended citation: Piety, N. Z., W. H. Reinhart, P. H. Pourreau, R. Abidi, and S. S. Shevkoplyas. "Shape matters: the effect of red blood cell shape on perfusion of an artificial microvascular network." Transfusion 56, no. 4 (2016): 844-851. DOI: 10.1111/trf.13449 This item has been deposited in accordance with publisher copyright and licensing terms and with the author’s permission.