Morphological and Chemical Changes in Stored Blood

Morphological and Chemical Changes in Stored Blood:

Physical Changes:-

(Changes occur rapidly at higher ambient temperatures)

RBC, WBC, Platelets, and Indices are stable for 8 hours (If stored at 4°C then up to 24 hours)

Morphological and Chemical Changes in Stored Blood

Later on:

PVC and MCV start increasing as RBCs are swollen
Osmotic fragility increases
ESR – Decreases
Prothrombin time prolonged

Morphological Changes

Start at 3 hours and striking at 12-18 hours.

Neutrophils

Nuclei stain more homogeneously
Nuclear lobes become separated
Ragged cytoplasmic margin
Small vacuoles appear in cytoplasm

Monocytes

Vacuoles appear in cytoplasm
Nucleus undergoes irregular lobulation

Lymphocytes

Vacuoles in cytoplasm
Nucleus stains more homogeneously
Nucleus undergoes budding

RBCs

Progressive crenation and sphering.

Biochemical Changes in Blood upon Storage:

Loss of CO2 – It diffuses from plasma into atmosphere.
Conversion of glucose to lactic acid by glycolysis.
Increased plasma inorganic phosphates-Formed from ester phosphates present in cells.
Increased ammonia-Formed from nitrogenous substances like urea.
Passage of intracellular material of RBC into plasma ex-potassium.
Conversion of pyruvate to lactate.

Note :-

To ensure even dispersal of blood cells , it is essential that specimens are mixed effectively immediately prior to taking a sample for testing.

Diagnostic Alerts:

Perform all investigation as soon as possible after the blood sample is taken.
Never freeze the sample on storing the sample at 4°C .
Perform all counts within two hours of blood collection.
Excessive EDTA in the sample will significantly lover TLC within 1 – 2 hours.
Refrigerated samples must always be brought to room temperature being used.

Reference

“Hoffbrand’s Essential Haematology” by A. Victor Hoffbrand, Paul A.H. Moss, and John E. Pettit: This is a comprehensive and highly regarded textbook that covers the fundamental principles of hematology.
“Williams Hematology” by Kenneth Kaushansky, Marshall A. Lichtman, Josef T. Prchal, Marcel M. Levi, Oliver W. Press, and Linda J. Burns: This is a renowned textbook that provides in-depth coverage of both clinical and basic aspects of hematology.

“Wintrobe’s Clinical Hematology” by John P. Greer, Daniel A. Arber, Bertil E. Glader, Alan F. List, Robert T. Means Jr., Frixos Paraskevas, George M. Rodgers, and Michael H. Schmitt: This classic text has been a staple in the field of hematology for many years and offers comprehensive information on various hematological disorders.
“Hematology: Basic Principles and Practice” by Ronald Hoffman, Edward J. Benz Jr., Leslie E. Silberstein, Helen Heslop, John Anastasi, and Jeffrey Weitz: This textbook provides a detailed overview of the principles and practice of hematology, including the latest advancements in the field.

“Clinical Hematology and Fundamentals of Hemostasis” by Denise M. Harmening: This book is a good choice for those looking for a comprehensive guide to both clinical hematology and hemostasis.
“Rodak’s Hematology: Clinical Principles and Applications” by Elaine M. Keohane, Larry Smith, and Jeanine M. Walenga: This text focuses on the clinical application of hematology concepts and includes practical information for laboratory professionals.

“Hematology in Clinical Practice” by Robert S. Hillman, Kenneth A. Ault, and Henry M. Rinder: This book is designed for healthcare professionals and provides a practical approach to hematology in a clinical setting.
“Consultative Hematology: An Issue of Hematology/Oncology Clinics of North America” edited by Mikkael A. Sekeres and Christopher R. Cogle: This book focuses on the consultative aspects of hematology and is a valuable resource for clinicians.

Morphological and Chemical Changes in Stored Blood