Cellular and Biochemical Effects of Combined X-Ray Radiation and Storage on Whole Blood

Dose Response. 2022 Jan 29;20(1):15593258211073100. doi: 10.1177/15593258211073100. eCollection 2022 Jan-Mar.


Background: Evaluating the impact of ionizing radiation on stored blood is relevant since blood banks are major assets in emergency conditions such as radiation incident/attack. This study aimed to fill our knowledge gap of combined radiation and storage effects on blood.

Methods: Blood collected from 16 anesthetized rats was anticoagulated, aliquoted into storage bags, and assigned to 8 groups using protocols combining storage (1-day vs 3-day 4oC) plus irradiation (75 Gy vs 0 Gy - control). Bags were positioned inside an X-ray irradiator (MultiRad-350). Complete blood count, differential white blood cell count, biochemistry, and hemostasis were analyzed (≥7 bags/group).

Results: Na+, bicarbonate, glucose, and pH significantly reduced, while K+, Cl-, and lactate increased by storage. Coagulation measures were not significantly altered after radiation. White blood cell count and most cell types were numerically reduced after radiation, but changes were statistically significant only for monocytes. No significant alterations were noted in aggregation or rotational thromboelastometry parameters between irradiated and control.

Conclusions: Evaluating cellular/biochemical parameters aids in assessing stored blood adequacy after radiation. Data suggest that fresh or cold-stored blood can sustain up to 75 Gy without major critical parameter changes and may remain suitable for use in critically ill patients in military/civilian settings.

Keywords: X-ray radiation; aggregometry; cell damage; cold storage; ionizing radiation; platelets; rat; resuscitation; storage lesion; whole blood.