Mannitol-adenine-phosphate: a novel solution for intraoperative blood salvage

作者：Yang, Ping; Zhou, Jing; Kang, Yi; Gong, Lina; Zhang, Jie; Yu, Jie; Yin, Xiaorong; Zhang, Chongwei; Liu, Guangyue; Liu, Jin; Du, Lei^*

来源：Transfusion, 2014, 54(4): 1146-1152.

DOI：10.1111/trf.12370

• PROTEIN-KINASE-C
• CELL SALVAGE
• HUMAN-ERYTHROCYTES
• CARDIAC-SURGERY
• MEMBRANE
• SHAPE
• DEFORMABILITY
• CONSERVATION
• TRANSFUSION
• ADENOSINE

BackgroundIntraoperative blood salvage (IBS) procedures include washing with normal saline (NS), which may deplete red blood cell (RBC) nutrients. The mannitol-adenine-phosphate (MAP) solution, commonly used for RBC preservation, provides glycolytic substrates; therefore, MAP should be a better solution than NS in IBS. In this study, we determined whether using MAP could reduce washing-associated RBC damage and destruction. @@@ Study Design and MethodsAdenine nucleotide contents, RBC morphology, and plasma free hemoglobin (PF-Hb) level of RBCs treated with NS or MAP solution were compared under three conditions: 1) 4-hour preservation of fresh blood from healthy volunteers, 2) collection from the shed blood of patients, and 3) incubation of the collected shed blood with plasma. @@@ ResultsAdenine nucleotide level and RBC elongation index were greater and PF-Hb level was lower in MAP groups than NS groups (p<0.05) after preservation and incubation. In NS, RBCs lost their deformability and became stomatocytes, and even RBC ghosts 48 hours after incubation, while they remained normal in MAP solution. @@@ ConclusionThe MAP solution helps preserve RBC morphology and function, and reduces hemolysis, possibly due to improved energy production. Therefore, MAP should replace NS during IBS.

• 出版日期2014-4
• 单位四川大学