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

Abstract

BACKGROUND:

Intraoperative 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 METHODS:

Adenine 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.

RESULTS:

Adenine 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.

CONCLUSION:

The MAP solution helps preserve RBC morphology and function, and reduces hemolysis, possibly due to improved energy production. Therefore, MAP should replace NS during IBS.

• Authors: Ping Yang, Jing Zhou, Yi Kang, Lina Gong, Jie Zhang, Jie Yu, Xiaorong Yin, Chongwei Zhang, Guangyue Liu, Jin Liu, Lei Du
• Journal: Transfusion (Transfusion) Vol. 54 Issue 4 Pg. 1146-52 (Apr 2014) ISSN: 1537-2995 [Electronic] United States
• PMID: 23927791 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2013 American Association of Blood Banks.

Chemical References

• Mannitol Phosphates
• Adenine

Topics

• Adenine (chemistry, pharmacology, therapeutic use)
• Blood Preservation (methods)
• Cell Shape (drug effects)
• Cells, Cultured
• Drug Evaluation, Preclinical
• Erythrocyte Deformability (drug effects)
• Erythrocytes (cytology, drug effects, physiology)
• Humans
• Mannitol Phosphates (chemistry, pharmacology, therapeutic use)
• Operative Blood Salvage (methods)