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Routine storage of red blood cell (RBC) units in additive solution-3: a comprehensive investigation of the RBC metabolome.

ABSTRACT: In most countries, red blood cells (RBCs) can be stored up to 42 days before transfusion. However, observational studies have suggested that storage duration might be associated with increased morbidity and mortality. While clinical trials are under way, impaired metabolism has been documented in RBCs stored in several additive solutions (ASs). Here we hypothesize that, despite reported beneficial effects, storage in AS-3 results in metabolic impairment weeks before the end of the unit shelf life.Five leukofiltered AS-3 RBC units were sampled before, during, and after leukoreduction Day?0 and then assayed on a weekly basis from storage Day?1 through Day?42. RBC extracts and supernatants were assayed using a ultra-high-performance liquid chromatography separations coupled online with mass spectrometry detection metabolomics workflow.Blood bank storage significantly affects metabolic profiles of RBC extracts and supernatants by Day?14. In addition to energy and redox metabolism impairment, intra- and extracellular accumulation of amino acids was observed proportionally to storage duration, suggesting a role for glutamine and serine metabolism in aging RBCs.Metabolomics of stored RBCs could drive the introduction of alternative ASs to address some of the storage-dependent metabolic lesions herein reported, thereby increasing the quality of transfused RBCs and minimizing potential links to patient morbidity.

SUBMITTER: D'Alessandro A

PROVIDER: S-EPMC4469527 | biostudies-literature | 2015 Jun

REPOSITORIES: biostudies-literature

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Routine storage of red blood cell (RBC) units in additive solution-3: a comprehensive investigation of the RBC metabolome.

D'Alessandro Angelo A Nemkov Travis T Kelher Marguerite M West F Bernadette FB Schwindt Rani K RK Banerjee Anirban A Moore Ernest E EE Silliman Christopher C CC Hansen Kirk C KC

Transfusion 20141230 6

<h4>Background</h4>In most countries, red blood cells (RBCs) can be stored up to 42 days before transfusion. However, observational studies have suggested that storage duration might be associated with increased morbidity and mortality. While clinical trials are under way, impaired metabolism has been documented in RBCs stored in several additive solutions (ASs). Here we hypothesize that, despite reported beneficial effects, storage in AS-3 results in metabolic impairment weeks before the end of ...[more]

PMID: 25556331

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Project description:The question of whether storage of red blood cells (RBCs) alters their capacity to deliver oxygen and affects patient outcomes remains in a state of clinical equipoise. Studies of the changes which occur while RBCs are stored have led to several physiologically plausible hypotheses that these changes impair RBC function when the units are transfused. Although there is some evidence of this effect in vivo from animal model experiments, the results of several largely retrospective patient studies have not been consistent. Some studies have shown an association between worse clinical outcomes and transfusion of RBC which have been stored for longer periods of time, while others have found no effect. Three multicenter, randomized, controlled trials have been developed to address this important, but currently unanswered, question. Two clinical trials, one in low birth weight neonates and the other in intensive care unit patients, are enrolling subjects in Canada (the Age of Red Blood Cells in Premature Infants; the Age of Blood Study). The third trial, which is being developed in the United States, is the Red Cell Storage Duration Study (RECESS). This is a multicenter, randomized, controlled trial in which patients undergoing complex cardiac surgical procedures who are likely to require RBC transfusion will be randomized to receive RBC units stored for either 10 or fewer days or 21 or more days. Randomization will only occur if the blood bank has enough units of RBC of both storage times to meet the crossmatch request; hence, subjects randomized to the 21 day arm will receive RBC of the same storage time as they would have following standard inventory practice of "oldest units out first". The primary outcome is the change in the Multiple Organ Dysfunction Score (MODS), a composite measure of multiorgan dysfunction, by day 7. Secondary outcomes include the change in the MODS by day 28, all-cause mortality, and several composite and single measures of specific organ system function. The estimated total sample size required will be 1434 evaluable subjects (717 per arm).

Dataset Information

Routine storage of red blood cell (RBC) units in additive solution-3: a comprehensive investigation of the RBC metabolome.

Publications

Routine storage of red blood cell (RBC) units in additive solution-3: a comprehensive investigation of the RBC metabolome.

Similar Datasets

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