Thesis Charles Lelkens
On 30 June 2017 (11:00 hrs) Charles Lelkens will defend his thesis 'Frozen Red Cells for Military and Civil Purposes. Relevance, Experiences and Developments' at the University of Amsterdam.
Promotor: Prof AJ Verhoeven PhD
Copromotores: D de Korte PhD and JWM Lagerberg PhD
Venue: Aula, Universiteit van Amsterdam, Singel
Summary

Massive blood loss still remains the major cause of death on the battlefield. Meeting transfusion needs under wartime conditions presents a formidable, logistical challenge. Regardless of the actual usage, a shelf life of 35 days for red cells requires shipments at least once a month. This easily leads to either wastage (low or no usage) or shortage (usage higher than expected). The solution is to apply freezing methods, of which the high-glycerol method is the most widely used. After thawing, however, the glycerol needs to be removed. Moreover, the current shelf life after thawing and washing is limited to 14 days.
This thesis describes possibilities to increase the practical applicability of frozen red cells. Combining adjustments of the washing fluid and the glycerolization method leads to less red cell damage, increasing their postthaw shelf life to 28 days. Prefreeze treatment with substances that increase the red cell’s energy content well above physiological levels not only extends their postthaw shelf life to 35 days, but also maintains their oxygen delivery capacity at a significantly higher level during the first two weeks of postthaw storage. The important practical implications of this thesis are that the results facilitate operating a frozen blood bank, by minimizing the effects of a time consuming deglycerolization procedure. Thus, the ability to maintain a liquid, previously frozen, inventory of red cells creates the possibility to better meet unexpected operational demands, as is the case under battlefield conditions.
Chapters
Chapter 1
Introduction
Chapter 2
Stability after thawing of RBCs frozen with the high- and low-glycerol method. Transfusion 2003;43(2):157-64
Chapter 3
Experiences with frozen blood products in the Netherlands military.
Transfus Apher Sci 2006;34(3):289-98
Chapter 4
Australian experience with frozen blood products on military operations.
Med J Aust 2010; 192(4):2035
Chapter 5
Prolonged postthaw shelf life of red cells frozen without prefreeze removal of excess glycerol.
Vox Sang 2015;108(3):219-25
Chapter 6
The effect of prefreeze rejuvenation on postthaw storage of red cells in AS-3 and SAGM. Transfusion. 2017; doi:10.1111/trf.14093 [Epub ahead of print].
Chapter 7
Advances in military, field, and austere transfusion medicine in the last decade. Transfus Apher Sci 2013;49(3):380-6
Chapter 8
General discussion
Chapter 9
Summary
Download
Download PhD thesis (university repository)