Effects of Cell Salvage on Erythrocyte 2,3-Disphosphoglycerate and G-6-PD Levels and Phosphatidylserine Expression

INTRODUCTION:

The aim of this study was to investigate the contribution of the perioperative cell salvage process to the changes in erythrocyte 2,3-disphosphoglycerate (2,3-DPG) and glucose-6-phosphate dehydrogenase (G-6-PD) levels and phosphatidylserine (PS) expression using a self-control study comparing washed blood with venous blood.

METHODS:

Thirty patients undergoing elective heart and blood vessel surgery were enrolled. Blood was collected and processed using a Fresenius continuous autotransfusion system device. 2,3-DPG and G-6-PD activities, as well as PS expression, from both venous and washed red blood cells (RBC) were measured. We also compared these indicators among washed RBC at 6 h, washed RBC at 0 h, and venous RBC.

RESULTS:

2,3-DPG and G-6-PD activities in washed blood at 0 h were significantly higher than in venous RBC (2,3-DPG, venous vs. washed blood P < 0.05; G-6-PD, venous vs. washed blood P < 0.05). Flow cytometry results showed no differences between venous blood and washed RBC at 0 h (n = 23, P > 0.05). 2,3-DPG activity in washed RBC that were allowed to stand for 6 h decreased compared with that in venous blood (venous vs. washed blood at 6 h P < 0.01), whereas no significant difference was observed in G-6-PD activity (venous. vs. washed blood at 6 h P > 0.05).

CONCLUSION:

Compared with venous RBC, washed RBC from intraoperative cell salvage exhibited good oxygen-carrying and antioxidant capacities. However, the oxygen-carrying capacity of washed RBC that were allowed to stand for 6 h was not as good as that of venous RBC. Thus, we suggest that washed RBC that were left to stand for more than 6 h should not be reinfused.