• Junko Ichikawa, Ichiro Koshino, Nobuto Arashiki, Fumio Nakamura, and Makiko Komori.
• Department of Anesthesiology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan. Electronic address: htwfx872@yahoo.co.jp.
• J. Cardiothorac. Vasc. Anesth. 2022 Mar 1; 36 (3): 855-861.

ObjectivesBlood-processing techniques and preservation conditions cause storage lesions, possibly leading to adverse outcomes after transfusion. The authors investigated the metabolic changes and deformability of red blood cells (RBCs) during storage and determined the effect of storage lesions on circulating RBCs during cardiac surgery.DesignProspective study.SettingTertiary care center affiliated with a university hospital.ParticipantsAdults who underwent elective cardiac surgery requiring cardiopulmonary bypass.InterventionsThe authors collected aliquots of autologous and irradiated allogeneic RBCs and blood samples from seven patients who received autologous whole blood and nine patients who received irradiated allogeneic RBCs before incision (baseline), at the start and end of cardiopulmonary bypass, and at completion of surgery.Measurements And Main ResultsThe authors analyzed RBC deformability, erythrocyte indices, and density distribution to evaluate blood banking-induced alterations of autologous and allogeneic RBCs and changes in circulating RBCs in recipients, after blood transfusion. Time-dependent biochemical changes and significant decreases in deformability during storage occurred in both groups; however, homologous RBCs had significantly lower deformability than autologous RBCs. Trends in mean corpuscular volume and mean corpuscular hemoglobin concentration differed in both groups. In the homologous transfusion group, during cardiac surgery, RBC deformability, mean corpuscular volume, and mean corpuscular hemoglobin concentration showed significant changes compared with baseline values, and a greater number of denser subpopulations was observed at surgery completion.ConclusionsBlood-processing techniques contribute to storage lesions, suggesting that transfusion of autologous whole blood, rather than allogeneic RBCs, could maintain the ability of circulating RBCs to deform and lead to potentially better transfusion outcomes.Copyright © 2021. Published by Elsevier Inc.

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