“…The survival values of the bloods stored for prolonged periods of time in ACD medium as indicated by the chromated cell method are lower by some 10 per cent than the values previously reported as determined by the radio-iron tagged cell method (1)(2)(3). This discrepancy might be explained by the fact that the hematocrit value employed in calculating red cell survival in these studies was not modified by a correction factor as was done in the studies on survival of radio-iron tagged cells.…”
One of the most useful methods available for the quantitative measurement of hemolytic rates in clinical subjects and for the evaluation of red cell viability after storage is based on the survival of transfused erythrocytes. Access to such data, however, has been restricted because of limitations in the methods hithertofore available for measuring red cell survival in vivo.The differential agglutination method of counting donor cells, the procedure most commonly employed, has limitations in that large transfusions are required;* the donor blood must be devoid of all antigenic isoagglutinins which are not likewise possessed by the recipient; the recipient's cells must contain agglutinogen A or B or M or a combination of the three agglutinogens which is not contained in the donor blood; and, finally, this method excludes the use of autotransfusion, which would eliminate the risk of transmission of hemologous serum jaundice.The labelling of donor cells with radioactive iron (Fe55) permits the conduct of survival studies on a short term basis (1-3) but re-utilization of radioactive iron released from hemolyzed donor cells and the subsequent incorporation of this label in the recipient's red cells preclude its use in studies extending for periods longer than 24 to 48 hours.
“…The survival values of the bloods stored for prolonged periods of time in ACD medium as indicated by the chromated cell method are lower by some 10 per cent than the values previously reported as determined by the radio-iron tagged cell method (1)(2)(3). This discrepancy might be explained by the fact that the hematocrit value employed in calculating red cell survival in these studies was not modified by a correction factor as was done in the studies on survival of radio-iron tagged cells.…”
One of the most useful methods available for the quantitative measurement of hemolytic rates in clinical subjects and for the evaluation of red cell viability after storage is based on the survival of transfused erythrocytes. Access to such data, however, has been restricted because of limitations in the methods hithertofore available for measuring red cell survival in vivo.The differential agglutination method of counting donor cells, the procedure most commonly employed, has limitations in that large transfusions are required;* the donor blood must be devoid of all antigenic isoagglutinins which are not likewise possessed by the recipient; the recipient's cells must contain agglutinogen A or B or M or a combination of the three agglutinogens which is not contained in the donor blood; and, finally, this method excludes the use of autotransfusion, which would eliminate the risk of transmission of hemologous serum jaundice.The labelling of donor cells with radioactive iron (Fe55) permits the conduct of survival studies on a short term basis (1-3) but re-utilization of radioactive iron released from hemolyzed donor cells and the subsequent incorporation of this label in the recipient's red cells preclude its use in studies extending for periods longer than 24 to 48 hours.
“…The 2 The term, viability, will be used throughout this series of papers to describe the maintenance of erythrocytes in circulation after transfusion into a suitable recipient. Thus, loss of viability refers to the excessive loss of erythrocytes from the circulation after transfusion but does not necessarily define the metabolic state of the cell.…”
Erythrocytes stored in an acid-citrate-dextrose preservative (ACD) at 4 to 7°C. undergo morphological and biochemical alterations. The cell becomes more sphere-shaped with an associated increase in osmotic and mechanical fragilities, the glycolytic rate and organic phosphate compounds are decreased, inorganic phosphate is increased, and the differential between cell potassium and sodium is decreased (1). These altered cells, when transfused to a recipient, are destroyed in an amount dependent upon the duration of storage of the blood. Thus, storage for three weeks in ACD results in a viability 2 of about 85 per cent and for four weeks in a viability of about 60 per cent (2, 3).Since the normal human erythrocyte population is destroyed in vivo at a rate of 0.8 to 1.0 per cent per day, the survival of erythrocytes after three to four weeks of storage is consistent with the expected in vivo loss from aging. The present study was undertaken to determine whether the changes of storage were related to a normal or accelerated aging process, or whether they represented cell damage due to in vitro storage conditions.
“…La conservation des culots a été l'objet de multiples travaux re cherchant en particulier des solutions favorables [3,10,11,16,25,38,40,41,42,43,46,55,60,81,82,83,94,97,100,101,102,103,104,107].…”
De 1948 à 1958 le Centre de Transfusion Réanimation de l’Armée (C.T.R.A.) a préparé 3191 transfusions sélectives de globules rouges, à partir de 4068 flacons de sang total, pour 486 malades. 2734 flacons ont été centrifugés puis le culot hématique a été dé- barassé d’environ 90 % du plasma surnageant. (Le C.T.R.A. désigne une telle préparation sous le nom de «culot globulaire».) 2370 transfusions ont été faites, soit: 2006 de culots simples, 364 de culots doubles. 1334 flacons ont subi la même préparation, puis le culot a été lavé à deux ou trois reprises pour obtenir des «hématies lavées» quasi-totalement débarrassées du plasma. 831 transfusions ont été faites, soit: 311 à partir d’un seul flacon de sang, 507 à partir de 2 flacons, 3 à partir de 3 flacons.
Le tableau I schématise les variations annuelles de la production de 1949 à 1957 (en 1948 n’ont été préparées que quelques transfusions d’hématies lavées; pour 1958, le travail ne porte que sur les 3 premiers mois de l’année). Nous nous proposons d’indiquer la technique utilisée par le C.T.R.A. et d’analyser les indications qui ont été satisfaites, de même que les incidents observés.
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