Las bolsas plásticas para sangre: un hito en la historia de la tecnología transfusional / Plastic blood bags: a landmark in the history of transfusional technology

Se presenta en este artículo una breve historia de los métodos utilizados para transfundir sangre humana, partiendo de las transfusiones de brazo a brazo, el uso de frascos de vidrio y la introducción de las bolsas de PVC en los Estados Unidos a mediados del siglo XX. Finalmente, se hace hincapié en el desarrollo de las bolsas para sangre en la Argentina, un trabajo interdisciplinario en el cual confluyeron la industria farmacéutica y los usuarios médicos.

Inhibition of membrane Na(+)-K+ Atpase of the brain, liver and RBC in rats administered di(2-ethyl hexyl) phthalate (DEHP) a plasticizer used in polyvinyl chloride (PVC) blood storage bags.

Significant amounts of di(2-ethylhexyl) phthalate (DEHP) leach out into blood stored in DEHP plasticized polyvinyl chloride (PVC) bags resulting in the exposure of recipients of blood transfusion to this compound. The aim of this study was to find out whether DEHP at these low levels has any effect on the activity of membrane Na(+)-K+ ATPase, since a decrease in this enzyme activity has been reported to take place in a number of disorders like neurodegenerative and psychiatric disorders, coronary artery disease and stroke, syndrome-X, tumours etc. DEHP was administered (ip) at a low dose of 750 microg/100 g body weight to rats and the activity of membrane Na(+)-K+ ATPase in liver, brain and RBC was estimated. Histopathology of brain, activity of HMG CoA reductase (a major rate limiting enzyme in the isoprenoid pathway of which digoxin, the physiological inhibitor of Na(+)-K+ ATPase is a product), intracellular concentration of Ca2+ and Mg2+ in RBC (which is altered as a result of inhibition of Na(+)-K+ ATPase) were also studied. (In the light of the observation of increase of intracellular Ca2+ load and intracellular depletion of Mg2+ when Na(+)-K+ ATPase is inhibited). Histopathology of brain revealed areas of degeneration in the rats administered DEHP. There was significant inhibition of membrane Na(+)-K+ ATPase in brain, liver and RBC. Intracellular Ca2+ increased in the RBC while intracellular Mg2+ decreased. However activity of hepatic HMG CoA reductase decreased. Activity of Na(+)-K+ ATPase and HMG CoA reductase, however returned to normal levels within 7 days of stopping administration of DEHP. The inhibition of membrane Na(+)-K+ ATPase activity by DEHP may indicate the possibility of predisposing recipients of transfusion of blood or hemodialysis to the various disorders mentioned above. However since this effect is reversed when DEHP administration is stopped, it may not be a serious problem in the case of a few transfusion; but in patients receiving repeated blood transfusion as in thalassemia patients or patients undergoing hemodialysis, possibility of this risk has to be considered. This inhibition is a direct effect of DEHP or its metabolites, since activity of HMG CoA reductase, (an enzyme which catalyses a major rate limiting step in the isoprenoid pathway by which digoxin, the physiological inhibitor of Na(+)-K+ ATPase is synthesized) showed a decrease.

Changes in the composition of erythrocyte membrane during storage of blood in di-(2-ethyl hexyl) phthalate [DEHP] plasticized poly vinyl chloride (PVC) blood storage bags.

Very little information is available on the changes in the erythrocyte membrane composition during storage of blood at 4 degrees C, particularly with respect to the glycosaminoglycans and glycoproteins. In view of this, a detailed study was carried out on the changes in the membrane proteins, glycosaminoglycans (GAG), carbohydrate components of glycoproteins, cholesterol, phospholipids and vitamin E in blood stored in glass bottles and a di-(2-ethyl hexyl) phthalate (DEHP) plasticized PVC bag (Penpol blood bag). Blood was collected in CPDA solution in glass bottles and in Penpol blood bags and kept at 4 +/- 1 degrees C. Analysis was made immediately after blood collection and after 28 and 42 days. Significant increase in the total protein in the erythrocyte membrane was observed during storage of whole blood in glass bottles and Penpol blood bag at 4 degrees C. This increase was progressively more with increase in storage time. Significant changes were also observed in GAG, carbohydrate components of glycoproteins, cholesterol, phospholipids and vitamin E in the erythrocyte membrane under these conditions. The protein:GAG ratio, protein:carbohydrate ratio, cholesterol:phospholipid ratio as well as protein:lipid ratio showed significant increase in the membrane. The extent of these changes was lower in the Penpol bag, indicating the stabilizing effect of DEHP on the erythrocyte membrane.

Diagnóstico serológico rápido de fiebre hemorrágica argentina en sangre entera / Rapid serologic diagnosis of Argentinian hemorrhagic fever in whole blood

Se estudió la utilidad de un nuevo método que permite conservar la actividad de anticuerpos en sangre entera, para el diagnóstico serológico de Fiebre Hemorrágica Argentina. Ratones N: NIH adultos fueron inoculados por vía intraperitoneal con 10**3 UFP de la cepa XJ-Clon 3 de virus Junín y fueron sangrados por unción retroorbital a los 21 días post-infección. Una aliquota de sangre (50 micronl) se colocó en tubos conteniendo una solución conservadora para sangre entera (equipo comercial) y el resto se procesó para la obtención de suero. Se investigó la presencia de anticuerpos por inmunofluorescencia indirecta sobre células BHK/21 persistentemente infectadas con virus Junín. Se detectaron altos títulos de anticuerpos (1/64 a 1/256) tanto al emplear sangre entera como suero, registrándose un 66% de coincidencia entre los títulos de anticuerpos con ambos procedimientos. Estos resultados señalan que el método de detección de anticuerpos en sangre entera podría ser de utilidad para la búsqueda de anticuerpos anti-virus Junín en forma rápida, lo que facilitaría la realización de estudios seroepidemiológicos en forma masiva en áreas endémicas