Clinical Use of Glycerolized Frozen Blood

Abstract

Since the discovery of human blood groups by Landsteiner in 1908,1 there have been only two significant developments in the ability to transfuse human blood. These are the use of an anticoagulant to permit the collection of blood at a location remote from the recipient and the development of anticoagulant acid citrate dextrose solution to permit the short-term storage of blood at ordinary refrigerator temperatures. Such methods were adequate for transfusion needs of civilian practice until comparatively recent times.With recent progress in medical and surgical skills resulting in the development of heart-lung oxygenators, kidney dialyzers, chemotherapeutic perfusion of isolated cancers, and other procedures requiring large volumes of blood for priming or replacement, the need for blood transfusion has steadily increased. At present a shortage of blood of proper type is often the limiting factor in definitive care of the patient. In addition, large stockpiles of human blood are also needed to meet civilian and military requirements in case of nuclear attack. Many methods of prolonging storage time of human blood have been reported, but none has successfully permitted storage longer than a few weeks.2 Smith and others:J showed that tissues exposed to glycerol and other polyhydric alcohols could be frozen and thawed without significant damage. They suggested that erythrocytes might be preserved in this manner, but the need to remove glycerol from the cells before transfusion prevented its immediate translation to red blood cell preservation. Although glycerol is nontoxic, the introduction of glycerolized blood cells into an aqueous solution such as plasma results in excessive swelling and rupture of the glycerolized blood cells because the rate of water endosmosis into the blood cells is four times the rate of glycerol exosmosis. The Cohn fractionator was developed in 1951 for the separation of blood into its component parts.4 It possesses certain features uniquely applicable to the glycerolization and deglycerolization of red blood cells. The fractionator contains a sterile centrifuge that operates under precise temperature control and has no limitations on the volume of solutions for perfusion of blood cells in the revolving bowl.A practical method now exists for the long-term preservation of human blood. Red blood cells which have been glycerolized, frozen at \p=m-\80C, and stored up to 44 months have been deglycerolized, reconstituted, and successfully given to patients. Over 1,014 units of frozen glycerolized blood have been administered to patients, with good clinical results and a low reaction rate. The Cohn fractionation method permits "tailoring" of the blood to fit the needs of the recipient. Frozen heparinized blood has been used as a priming fluid for extracorporeal circulation. Frozen plasma retains full heparin activity after storage for five months. The stockpiling of blood of rare types and banking by donors for future elective autotransfusions can now be done.The stockpiling of blood for use in the ...

Frozen blood and lessons learned from 9/11

“…26,27 The ability to store fRBCs for 10 years vs. 42 days allows contingency planning for both shortages and excessive demand. 10 Wastage rates become increasingly important during known cyclical blood shortages that occur over the summer months and winter holiday season. 28 The donation rate of 4.5% was the lowest since 1997, and made more egregious by a 9.7% increase in the number of units transfused.…”

“…10,15,46 This was partially attributed to the washing step, significantly reducing the amount of hepatitis B antigen in fRBCs. An unintended benefit of the process is a decreased rate of transfusion-related infections and removal of residual whole blood components in pRBCs.…”

“…10,13,48,49 After the cells are washed, there are significantly fewer WBCs and less than 0.5 mL of plasma left in the product. 10,13,48,49 After the cells are washed, there are significantly fewer WBCs and less than 0.5 mL of plasma left in the product.…”

Lifespan of Preserved Red Cells1

“…The in virto loss of red blood cells ranged from 20.0 to 27.4 % (5 studies). (2) Red blood cells were glycerolized using the Cohn Blood Fractionator [8]. After thawing, deglycerolization was accomplished by continuous centrifugation in the reusable ADL bowl.…”

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