Effects of storage duration of suspended red blood cells before intraoperative infusion on coagulation indexes, routine blood examination and immune function in patients with gastrointestinal tumors

Abstract

Objective: To investigate the effect of storage duration of suspended red blood cells (SRBC) before intraoperative infusion on coagulation indexes, routine blood examination and immune function in patients with gastrointestinal (GI) tumors.
 Methods: We divided clinical data of one hundred patients with GI tumors who underwent surgical treatment in our hospital into two different groups according to the storage duration of SRBC use for intraoperative infusion. The short-term group (n=50) had patients with SRBC storage durations shorter than two weeks, and the long-term group (n=50) had patients with storage durations longer than two weeks. We compared the coagulation, immune function, routine blood profile, electrolyte levels and adverse reactions assessment results between the two groups.
 Results: Compared with before transfusions, the levels of fibrinogen (FIB) and activated partial prothrombin time (APTT) after blood transfusions were higher than those before transfusion (P<0.05). The levels of hemoglobin (Hb) and hematocrit (HCT) in the two groups after blood transfusions were also higher than those before transfusion (P<0.05). However, the levels of CD4+ decreased and those of CD8+ increased in both groups after the blood transfusions. In addition, the levels of CD4+ and CD4+/CD8+ in the short-term group were higher than those of the long-term group (P<0.05) while the CD8+ levels were lower than that of the long-term group (P<0.05). After the blood transfusions, the potassium ion (K+) levels in the two groups increased, and those in the long-term group were higher than in the short-term group (P<0.05). The sodium ion (Na+) levels in the two groups increased after the transfusions, and the short-term group had higher levels than the long-term group (P<0.05). Finally, the incidence of adverse reactions in the short-term group (4.00%) was lower than that in the long-term group (18.00%) (P<0.05).
 Conclusion: Intraoperative infusion of SRBC with storage duration longer than two weeks increases the risk of perioperative adverse transfusion reactions, which implies that the storage duration of SRBC should be strictly controlled in clinical practice to reduce the risk of blood transfusion.
 doi: https://doi.org/10.12669/pjms.39.1.7031
 How to cite this: Lan X, Chen Y, Bi Q, Xu W, Huang J. Effects of storage duration of suspended red blood cells before intraoperative infusion on coagulation indexes, routine blood examination and immune function in patients with gastrointestinal tumors. Pak J Med Sci. 2023;39(1):---------. doi: https://doi.org/10.12669/pjms.39.1.7031
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Procoagulant activity of red blood cell microparticles in stored packed red blood cell units and its relation to ABO blood grouping

“…The quantity of RMPs in RBC concentrates depends on the manufacturing techniques, the different additive solutions, and the variability of donors [2]. The existence of RMPs in blood units can cause severe transfusion reactions such as thrombosis, inflammation, and immunomodulation on behalf of their procoagulant and pro-inflammatory abilities [3,4]. The procoagulant activity of RMPs arose from the presence of a negatively charged phospholipid on their outer surface (phosphatidyl serine), which is important for the production of thrombin [5].…”