Biochemical and Cellular Changes in Leukocyte-Depleted Red Blood Cells Stored for Transfusion

Abstract

Background: To evaluate biochemical and cellular changes associated with the storage of leukocyte-depleted red blood cells (RBCs). Methods: We investigated 10 leukocyte-depleted RBC units, randomly chosen from volunteer donors. Every week an aliquot was collected for laboratorial evaluation, which included complete cell blood count, glucose-6-phosphate dehydrogenase (G6PD) activity, extracellular sodium, potassium and pH, membrane-bound hemoglobin (MBH), band 3 profile, and quantification of RBC membrane proteins composition. Results: We observed an increase in mean cell volume (from 91.86 ± 4.65 fl to 98.10 ± 5.80 fl, day 0 vs. day 21; p < 0.05), red cell distribution width, percentage of macrocytic RBCs, reticulocyte hemoglobin content and a decreased percentage of microcytic RBCs, mean cell volume concentration and G6PD activity. The extracellular concentration of sodium decreased, and that of potassium increased significantly over time. RBC membrane composition revealed an increase in spectrin/ankyrin ratio after 21 days (from 4.84 ± 0.99 to 5.27 ± 0.94, day 0 vs. day 21; p < 0.05). At day 35, a decrease in ankyrin (from 6.44 ± 1.70% to 5.49 ± 1.96%, day 0 vs. day 35; p < 0.05), in protein 4.1/band 3, protein 4.2/band 3, and ankyrin/band 3 ratios and in band 5 was observed. Conclusions: Our data show that leukocyte-depleted RBCs present changes in the RBC morphology, membrane protein composition, enzymatic activity, and extracellular electrolyte concentration and pH.

Glucose‐6‐phosphate dehydrogenase activity decreases during storage of leukoreduced red blood cells

“…Fluorescence in RBCs due to G6PD activity is dependent on the amount of oxyhemoglobin per RBC and could thus be explained by a decrease in Hb content of the RBC, by a change in the structure of Hb that prevents production of a fluorescent product after interaction with cyanide, or by decreased output of the PPP and thus decreased capacity of the RBC to reduce methemoglobin to oxyhemoglobin. The changes in electrolyte and Hb content in our samples are comparable to those reported in other studies on stored leukoreduced RBC products . Hb content in our study did not change significantly, which makes it unlikely that a decrease in RBC Hb content explains the decrease in fluorescence …”

“…The changes in electrolyte and Hb content in our samples are comparable to those reported in other studies on stored leukoreduced RBC products . Hb content in our study did not change significantly, which makes it unlikely that a decrease in RBC Hb content explains the decrease in fluorescence …”

“…Another study investigated transfusion products that, as in this study, were stored in CPD‐SAGM. In this study decreased G6PD activity could be detected with spectrophotometry . This is in contrast with an investigation that used RBCs stored in AS‐1, AS‐3, or AS‐5.…”

Biochemical evaluation of the effects of storage on feline erythrocytes

“…, Nogeira et al . ). The concentrations of these ion transporters are lower on the membranes of canine and feline red blood cells, explaining why similar changes are not identified in these species (Sha'afi & Hajjar , Castranova et al .…”

“…Lactate concentrations increased throughout the study period, which will contribute to acidification of the solution (Nogeira et al . ). By the end of the study, individual pH dropped below 6·0 in some samples.…”