Effects of Aged Stored Autologous Red Blood Cells on XXXX Endothelial Function.

@entity1 @entity20503 @entity842 @entity2142 @entity934
RATIONALE: A major abnormality that characterizes the red cell "storage lesion" is increased @entity2142 and reduced red cell lifespan after infusion. Low levels of @entity2142 after transfusion of aged stored red cells disrupt @entity842 (NO) bioavailabity, via accelerated NO scavenging reaction with cell free plasma hemoglobin. The degree of @entity2142 post-transfusion and effects on endothelial-dependent vasodilation responses to @entity934 have not been fully characterized in @entity1 . OBJECTIVES: To evaluate the effects of blood aged to the limits of FDA approved storage time on the @entity1 microcirculation and endothelial function. METHODS: Eighteen healthy individuals donated 1 unit of leukopheresed red cells, divided and autologously transfused into the forearm brachial artery 5 and 42-days after blood donation. Blood samples were obtained from stored blood bag supernatants and the antecubital vein of the infusion arm. Forearm blood flow measurements were performed using strain gauge plethysmography during transfusion, followed by testing of endothelium-dependent blood flow with increasing doses of intra-arterial @entity934 . MEASUREMENTS AND MAIN RESULTS: We demonstrate that stored, aged blood has higher levels of @entity20503 and cell free plasma hemoglobin. Compared to 5-day blood, the transfusion of 42-day packed red cells decreases @entity934 -dependent forearm blood flows. Intravascular venous levels of @entity20503 and cell free plasma hemoglobin increase immediately after red cell transfusion, with more significant increases observed after infusion of 42-day old blood. CONCLUSIONS: We demonstrate that the transfusion of blood at the limits of FDA-approved storage has a significant effect on the forearm circulation and impairs endothelial function. Clinical trial registration available at www.clinicaltrials.gov, ID NCT01137656.
