The survival of human erythrocytes in vitro and in vivo

Abstract

A quantitative method for determining the number of donor erythrocytes in the blood stream of a recipient is described. Briefly, group O blood is given to a group A recipient; after transfusion two types of cells are present in a sample of the recipient's blood. The recipient's cells are agglutinated with anti-A serum and the free donor cells counted. The in vivo survival of blood, stored for varying times in many recommended and test diluents was determined. A study of the progressive changes in osmotic and mechanical fragilities, degree of haemolysis and pH was made in order to discover whether any correlation existed between in vitro properties and 'in vivo' survival. Judged on the criterion of in vivo survival blood stored without glucose was found to deteriorate after 5 days. Blood stored with glucose lost little of its therapeutic value during 21 days storage. A mixture recommended by Rous and Turner (1916) in which blood is diluted with a large volume of 5.4% glucose was found to be the best diluent, in vivo survival not being impaired until after a month's storage. In vitro tests were found to be no guide to good 'in vivo' survival. Increase in osmotic fragility particularly may lead to most fallacious conclusions. The increased osmotic fragility of cells stored in the Rous-Turner diluent is reversed by plasma or isotomic saline. The superior survival of the Rous-Turner mixture may be due the decreased sedimentation rate and therefore slowly lysolecithin formation.