Clinical practice guideline of transfusion: survival and oxygen-carrying capacity of red blood cells

This study aimed at investigating the effect of in vitro preservation on survival and oxygen-carrying capacity of RBCs and obtaining clear and definite function change of RBCs during their preservation. The transfusion of fresh red blood cells (RBCs) is recommended for transfusion-dependent patients. 0-dayand 35-day-stored RBCs are still equally used in clinical practice now, which may influence the therapy effect of blood transfusion. The survival of 3-day-, 10-dayand 21-day-stored RBCs after blood transfusion was determined by flow cytometry based on natural differences in RBC antigens between donors and patients. The effect of in vitro preservation on RBC oxygen-carrying capacity was assessed by determining p50 and effective oxygen-carrying amount with blood-gas analyzer. In this study, we found that the PTR of RBCs decreased with storage time increasing, and the mean 24-h PTR of 3-day-, 10-day-, and 21-day-stored RBCs complied with the standard of RBC viability (i.e. the survival of the cells at least 75 percent at 24 h after transfusion). The mean potential life span (MPL) and time to reach a PTR of 50 percent of the 24-h PTR (T50) of 3-day-, 10-day-, and 21-day-stored RBCs are almost identical. In vitro studies showed that both p50 and effective oxygen-carrying amount of RBCs decreased with storage time increasing. In addition, the number of survival cells in the different RBC suspensions with same total effective oxygen-carrying amount had no significant difference. These findings provide theoretical basis and practical direction for scientific and efficient blood transfusion.