The spleen and haemolysis: evaluation of the intrasplenic transit time

Abstract

The mean intrasplenic red cell transit time (STT) and the slow mixing splenic red cell volume (SSV) have been measured in patients with hereditary spherocytosis (HS), autoimmune haemolytic anaemia (AIHA) and lymphoproliferative disease (LD). There was an inverse relationship between the mean red cell life span (MRCLS) and the STT in HS (r = -0.96, P less than 0.001) and in AIHA (r = -0.90, P less than 0.001). No such relationship existed in LD. The size of the spleen and the SSV were not related to the severity of haemolysis. Our data offer strong evidence for the conditioning effect of the spleen on HS- and AIHA red cells and suggest that the STT is an index of the adverse effect of the spleen on red cells in patients with HS or AIHA.

Temporal differences in membrane loss lead to distinct reticulocyte features in hereditary spherocytosis and in immune hemolytic anemia

“…Loss of cell surface area resulting in increased sphericity 18,23,24 is detrimental for red cell deformability and there is experimental evidence that these spherical cells are rapidly sequestered from circulation by the spleen. 5,9,11,[25][26][27][28][29][30] Hemolytic anemia characterized by spherocytic red cells with reduced membrane surface area is a feature of HS 1,2,19 and of some forms of AIHA. 4 In HS, the spherocyte formation has long been attributed to the increase propensity of abnormal red cells to shed membrane during their sojourn in circulation due to improper assembly of membrane proteins [6][7][8] whereas in AIHA it is due to partial phagocytosis 4 of the circulating red cell membrane bound antibodies complexes by macrophages.…”

“…Life span of spherocytic red cells has been shown to negatively correlate with the mean intrasplenic red cell transit, in HS and AIHA. 24,25,34,35 In addition to removing damaged or senescent red cells from the circulation, the spleen also plays a role in reticulocyte membrane remodeling. [36][37][38] Remodeling of reticulocytes into mature red cells involves loss of lipid membrane, 31,39,40 loss of surface area, 12,19,41 and decrease in cell volume.…”

Oxidative Injury to Erythrocytes, Cell Rigidity and Splenic Hemolysis in Hemodialyzed Patients before and during Erythropoietin Treatment

“…Red cell volume (RC'V), the splenic red cell volume (SRCV), the slow mixing red cell volume (SSV) and the intrasplenic red cell transit time (STT) were measured using the method described by Ferrant et al [15]. The measurements were performed before the EPO treatment and repeated in all patients when a stable HC'T between 30 and 35% had been established at least for 4 months.…”

Esferocitosis hereditaria. Revisión. Parte I. Historia, demografía, etiopatogenia y diagnóstico

“…El tiempo de tránsito a través de los cordones esplénicos, que es de 30-40 segundos para un eritrocito normal, se encuentra prolongado a 15-150 minutos en el caso de los esferocitos. 34 En consecuencia, el bazo de pacientes con ESH presenta cordones congestionados de modo masivo, pero con sinusoides relativamente vacíos, lo cual contrasta con la situación observable en bazos normales. Durante su detención en el bazo, los esferocitos sufren distintos cambios, que los llevan finalmente a su destrucción (Figura 4).…”

“…Durante su detención en el bazo, los esferocitos sufren distintos cambios, que los llevan finalmente a su destrucción (Figura 4). 6,7,15,[32][33][34][35][36][37][38] …”