Abstract
Objective: Unexpectedly wide distribution (<10 to >90%) of hemoglobin oxygen saturation (sO2) within red cell concentrates (RCCs) has recently been observed. Causes of such variability are not yet completely explained whereas the roles of oxygen and oxidative lesions during the storage of RCCs are known. The objectives of the present study are to characterize sO2 distribution in RCCs produced in a Swiss blood center and to investigate the influence of processing and donors’ characteristics.Methods: The level of sO2 was measured in 1701 leukocyte-depleted RCCs derived from whole blood donations in both top–bottom (TB; component filtered, SAGM) and top–top (TT; whole blood filtration, PAGGSM) RCCs. The sO2 value was measured non-invasively through the PVC bag prior to storage by resonance Raman spectroscopy. Gender, age, blood type, hemoglobin level, and living altitude of donors, as well as process method and time-to-process were recorded.Results: Overall, the sO2 exhibited a wide non-Gaussian distribution with a mean of 51.2 ± 18.5%. Use of top-top kits resulted in a 16% higher sO2 (P < 0.0001) than with top-bottom ones. Waiting time before processing only had a modest impact, but the blood processing itself reduced the sO2 by almost 12% (P < 0.0001). sO2 was also significantly affected by some donors’ characteristics. RCCs from men exhibited 25% higher sO2 (P < 0.0001) than those donated by women. Multivariate analysis revealed that the apparent correlation observed with hemoglobin level and age was actually due to multicollinearity with the sex variable. Finally, we noticed no significant differences across blood type but found that altitude of residence was associated with the sO2 (i.e., higher in higher living place).Conclusion: These data confirm wide sO2 distribution in RCCs reported recently. The sO2 was impacted by the processing and also by donors’ characteristics such as the gender and the living altitude, but not by the hemoglobin level, blood group and donor age. This study provides new hints on the factors influencing red blood cells storage lesions, since they are known to be related to O2 content within the bags, giving clues to better process and to better store RCCs and therefore potentially improve the efficacy of transfusion.
Highlights
Oxygen is required for aerobic organisms’ growth and survival
Red cell concentrates (RCCs) from 1,701 healthy donors were analyzed in the framework of this study
It is the Hb that gives their red color to the red blood cells (RBCs), the tint of which depends on how many oxygen molecules are bound by the heme group
Summary
Oxygen is required for aerobic organisms’ growth and survival. oxidative phosphorylation, which consists in the reduction of O2 to H2O in the mitochondria, drives ATP production (Nelson and Cox, 2005). Transport of oxygen from the lungs to the tissues and of carbon dioxide the other way round is guaranteed by the red blood cells (RBCs) These cells, which are by far the most abundant host cell type within the human body (Greer et al, 2018), have specialized to optimize their gas carrier function. They lose their nucleus and most organelles during their maturation process so that their cytoplasm ends up mainly filled with hemoglobin [Hb; 92% of dry mass (Nemkov et al, 2018)]. To counteract the oxidative burden they are exposed to (because of their close interaction with O2 and the high levels of iron), RBCs possess powerful enzymatic and non-enzymatic antioxidant defenses (Cimen, 2008)
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