BACKGROUND: Intraoperative blood salvage (IBS) procedures include washing with normal saline (NS), which may deplete red blood cell (RBC) nutrients. The mannitol-adenine-phosphate (MAP) solution, commonly used for RBC preservation, provides glycolytic substrates; therefore, MAP should be a better solution than NS in IBS. In this study, we determined whether using MAP could reduce washing-associated RBC damage and destruction. STUDY DESIGN AND METHODS: Adenine nucleotide contents, RBC morphology, and plasma free hemoglobin (PF-Hb) level of RBCs treated with NS or MAP solution were compared under three conditions: (1) 4-hour preservation of fresh blood from healthy volunteers, (2) collection from the shed blood of patients, and 3) incubation of the collected shed blood with plasma. RESULTS: Adenine nucleotide level and RBC elongation index were greater and PF-Hb level was lower in MAP groups than NS groups (p < 0.05) after preservation and incubation. In NS, RBCs lost their deformability and became stomatocytes, and even RBC "ghosts" 48 hours after incubation, while they remained normal in MAP solution. CONCLUSION: The MAP solution helps preserve RBC morphology and function, and reduces hemolysis, possibly due to improved energy production. Therefore, MAP should replace NS during IBS.
BACKGROUND: Intraoperative blood salvage (IBS) procedures include washing with normal saline (NS), which may deplete red blood cell (RBC) nutrients. The mannitol-adenine-phosphate (MAP) solution, commonly used for RBC preservation, provides glycolytic substrates; therefore, MAP should be a better solution than NS in IBS. In this study, we determined whether using MAP could reduce washing-associated RBC damage and destruction. STUDY DESIGN AND METHODS: Adenine nucleotide contents, RBC morphology, and plasma free hemoglobin (PF-Hb) level of RBCs treated with NS or MAP solution were compared under three conditions: (1) 4-hour preservation of fresh blood from healthy volunteers, (2) collection from the shed blood of patients, and 3) incubation of the collected shed blood with plasma. RESULTS:Adenine nucleotide level and RBC elongation index were greater and PF-Hb level was lower in MAP groups than NS groups (p < 0.05) after preservation and incubation. In NS, RBCs lost their deformability and became stomatocytes, and even RBC "ghosts" 48 hours after incubation, while they remained normal in MAP solution. CONCLUSION: The MAP solution helps preserve RBC morphology and function, and reduces hemolysis, possibly due to improved energy production. Therefore, MAP should replace NS during IBS.
Authors: Neil Blumberg; Jill M Cholette; Anthony P Pietropaoli; Richard Phipps; Sherry L Spinelli; Michael P Eaton; Suzie A Noronha; Jerard Seghatchian; Joanna M Heal; Majed A Refaai Journal: Transfus Apher Sci Date: 2018-02-21 Impact factor: 1.764
Authors: Ryunosuke Ohkawa; Hann Low; Nigora Mukhamedova; Ying Fu; Shao-Jui Lai; Mai Sasaoka; Ayuko Hara; Azusa Yamazaki; Takahiro Kameda; Yuna Horiuchi; Peter J Meikle; Gerard Pernes; Graeme Lancaster; Michael Ditiatkovski; Paul Nestel; Boris Vaisman; Denis Sviridov; Andrew Murphy; Alan T Remaley; Dmitri Sviridov; Minoru Tozuka Journal: J Lipid Res Date: 2020-09-09 Impact factor: 5.922
Authors: Kai Mei; Lei Du; Min Yan; Zhaohui Zhang; Fengjiang Zhang; Lina Gong; Kai Sun; Jie Zhang; Yumin Tang; Chunling Jiang; Jin Liu Journal: PLoS One Date: 2015-06-22 Impact factor: 3.240