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In a new article published in Blood, the journal of the American Society of Hematology, researchers from the Department of Physiology, Anatomy, and Genetics (DPAG) and The Nuffield Department of Surgical Sciences (NDS) at the University of Oxford present compelling evidence that challenges established notions about oxygen delivery during organ perfusion.

blood cells

A paper, titled Impaired O2 Unloading from Stored Blood Results in Diffusion-Limited O2 Release at Tissues: Evidence from Human Kidneys, authored by DPAG's Julija Rabcuka and NDS’s Richard Dumbill (DPhil student and clinical research fellow in transplant surgery) and DPAG's Pawel Swietach, sheds light on a critical aspect of oxygen transport often overlooked in traditional approaches.  

Contrary to the prevailing belief that effective blood circulation is the primary determinant of oxygen delivery, this research delves into the intrinsic properties of red blood cells (RBCs) and their ability to carry oxygen. The study, particularly focusing on stored blood used in transfusions, unveils a range of kinetic dysfunctions in the oxygen-unloading process, challenging the assumption of rapid oxygen exchange at capillaries.  

"Our research indicates that the quality of the blood itself plays a pivotal role in oxygen delivery to organs. Switching to biochemically rejuvenated blood during perfusion rapidly increased the kidney’s O2 diffusive capacity and cortical oxygenation. Our findings challenge the paradigm that O2 exchange at capillaries is invariably rapid and highlight the need to consider RBC gas-handling properties, justifying efforts to optimise blood storage regimes or rejuvenation protocols," explained Julija Rabcuka.  

The findings not only challenge established paradigms but also underscore the importance of considering RBC gas-handling properties. The research team advocates for a re-evaluation of blood storage regimes and rejuvenation protocols to optimise oxygen delivery during organ perfusion.  

This research marks a fundamental shift in our understanding of organ perfusion. By focusing on the nuanced gas-handling properties of RBCs, the research has far-reaching implications for refining medical practices, particularly in surgical scenarios involving the use of stored blood. 

Read the paper here

Julija Rabcuka, Richard Dumbill, and John Fallon performing twinned normothermic machine perfusion (NMP) of a human kidney using stored and rejuvenated blood.

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