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dc.contributor.authorMcLellan, Stuart Andrewen
dc.date.accessioned2018-03-29T12:18:51Z
dc.date.available2018-03-29T12:18:51Z
dc.date.issued2006en
dc.identifier.urihttp://hdl.handle.net/1842/29268
dc.description.abstracten
dc.description.abstract1.1 BACKGROUND Anaemia is a common finding in critically ill patients. Currently, the transfusion of stored blood is the only treatment available to most patients. Despite this reliance on blood transfusion there is a marked lack of data about both the efficacy of red cell transfusion products and the clinical situations in which they are likely to be effective. It has recently been suggested that red blood cell (RBC) transfusions may have detrimental effects in critically ill patients and that these effects may be related to the transfusion of stored RBCs in particular. It is well recognised that RBCs undergo many metabolic and structural changes during refrigerated storage, these changes are termed the red cell storage lesion. The clinical implications of the red cell storage lesion are not known.en
dc.description.abstract1.2 AIM To assess the implications of the red cell storage lesion of the current UK RBC product, namely leucodepleted RBCs stored in saline-adenine-glucose-mannitol additive solution, using a combination of in vitro and in vivo studies.en
dc.description.abstract1.3 Methods 1. The quality of the current RBC product was assessed using in-vitro assays of RBC oxygenation/de-oxygenation, namely P50 and the 2,3 diphosphoglycerate concentration, and RBC deformability. || 2. Radiolabel studies were performed to determine the 24 and 48-hour recovery of stored allogeneic blood in critically ill patients. || 3. The in-vivo regeneration of red cell 2,3 diphophoglycerate (2,3 DPG) in stored blood transfused to critically ill patients was investigated. || 4. Antigenic differences between donor and recipient were used to track allogeneic RBCs following therapeutic transfusions to determine RBC survival using a nonradioisotopic technique.en
dc.description.abstract1.4 RESULTS 1. In-vitro tests showed that current collection processing and storage procedures: (a) Result in a very rapid reduction in red cell 2,3 DPG concentration. Approximately 50% of 2,3 DPG had been lost by day 2 of storage and it was barely detectable by day 14. The in-vitro Ps0 also decreased rapidly during storage; the time-frame of the decrease matched that of the decrease in 2,3 DPG. || (b) Result in a slight reduction in red cell deformability. 2. The current red cell product, stored for between 10 to 29 days, had a mean 24-hour recovery of 91% in critically ill patients. || 3. Following transfusion to critically ill patients stored blood rapidly regenerated 2,3 DPG. || 4. Red cell antigens were used to track allogeneic red cells for up to 12 weeks post¬ transfusion. The estimated median red cell lifespan was 104 days (range 86 to 124 days).en
dc.description.abstract1.5 CONCLUSIONS Current red cell storage methods fail to maintain red cell 2,3 DPG and result in a loss of red cell deformability. Although 2,3 DPG regeneration was found to occur rapidly it still took 24 to 72 hours for levels to approach normal; whether or not this is clinically significant is not known.en
dc.description.abstractThe current UK red blood cell product has good short-term and long-term survival characteristics following therapeutic transfusion.en
dc.publisherThe University of Edinburghen
dc.relation.isreferencedbyAlready catalogueden
dc.subjectAnnexe Thesis Digitisation Project 2018 Block 17en
dc.titleThe red cell storage lesion and therapeutic blood transfusion in the critically ill patienten
dc.typeThesis or Dissertationen
dc.type.qualificationlevelDoctoralen
dc.type.qualificationnamePhD Doctor of Philosophyen


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