Washing stored red blood cells in an albumin solution improves their morphological and hemorheological properties


BACKGROUND Prolonged storage of red blood cells leads to storage lesions, which may impair clinical outcomes after transfusion. A hallmark of storage lesions is progressive echinocytic shape transformation, which can be partially reversed by washing in albumin solutions. Here we have investigated the impact of this shape recovery on biorheological parameters.

METHODS Red blood cells stored hypothermically for 6–7 weeks were washed in a 1% human serum albumin solution. Red cell deformability was measured with osmotic gradient ektacytometry. The viscosity of red cell suspensions were measured with a Couette-type viscometer. The flow behaviour of red cells suspended at 40% hematocrit was tested with an artificial microvascular network.

RESULTS Washing in 1% albumin reduced higher degrees of echinocytes and increased the frequency of discocytes, thereby shifting the morphological index towards discocytosis. Washing also reduced red cell swelling. This shape recovery was not seen after washing in saline, buffer or plasma. Red cell shape normalisation did not improve cell deformability measured by ektacytometry, but it tended to decrease suspension viscosities at low shear rates and improved the perfusion of an artificial microvascular network.

CONCLUSIONS Washing of stored red blood cells in a 1% human serum albumin solution specifically reduces echinocytosis, and this shape recovery has a beneficial effect on microvascular perfusion in vitro. Washing in 1% albumin may represent a new approach to improving the quality of stored red cells, and thus potentially reducing the likelihood of adverse clinical outcomes associated with transfusion of blood stored for longer periods of time.




Copyright 2015 Transfusion. This is a post-print version of a published paper that is available at: https://onlinelibrary.wiley.com/doi/full/10.1111/trf.13052 Recommended citation: Reinhart, W. H., N. Z. Piety, J. W. Deuel, A. Makhro, T. Schulzki, N. Bogdanov, J. S. Goede, A. Bogdanova, R. Abidi, and S. S. Shevkoplyas. "Washing stored red blood cells in an albumin solution improves their morphologic and hemorheologic properties." Transfusion 55, no. 8 (2015): 1872-1881. DOI: 10.1111/trf.13052 This item has been deposited in accordance with publisher copyright and licensing terms and with the author’s permission.