Rheologic changes of hypothermic preserved red blood cells

PhD ceremony: Ms. S. Henkelman, 14.30 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Rheologic changes of hypothermic preserved red blood cells

Promotor(s): prof.dr. G. Rakhorst, prof.dr. ir. H.J. Busscher

Faculty: Medical Sciences

Blood transfusions are being practiced worldwide. During refrigerated storage the red blood cells (RBCs) undergo changes that could hamper them to function adequately after infusion. Rheological properties are important determinants of the quality of RBCs. Impaired rheological properties, such as enhanced aggregability, reduced deformability, and elevated adherence to endothelial cells, propose a circulatory risk by hindering adequate tissue perfusion and contributing to ischemia or even infarction in the micro-vascular environment. We studied the rheological properties of RBCs to gain a better understanding of their quality in transfusion medicine, as well as to explore the utilization of cryopreserved RBCs for routine clinical practice. We demonstrated that 200-kDa HES polymers are useful pro-aggregants in RBC rheological studies. Furthermore, we demonstrated that the aggregability and deformability of RBCs were well preserved during routine blood bank storage, but the ATP content was gradually declining. To reduce storage induced lesion, RBCs are routinely cryopreserved, but unfamiliarity with their quality has also limited clinical use. We demonstrated that the freezing procedure did not adversely affect the aggregability, deformability or ATP content of cryopreserved RBCs. Also, the feasibility of a new Bio-freezer was investigated as a way to improve the clinical applicability of cryopreserved RBCs. Usage of the liquid Bio-freezer in combination with the -80°C mechanical freezer, enabled preservation of RBCs with 20% glycerol, while maintaining the RBC integrity, deformability and high 48-hour post-transfusion survival values. The results of this thesis will contribute to knowledge about the quality of stored RBCs and could contribute to expanding the utilization of cryopreserved RBCs in clinical practice.