lean said:
I think you mean refrigerated storage. No one is keeping blood at room temps for very long.
I know you know this but it could really confuse the uninformed.
Someone here is paying attention! Yes, indeed, my bad, I meant refrigerated storage. Unless, of course, you can't afford a Landis to stay in the apartment while you're gone and make sure the power to the fridge doesn't go out.
This is what I don't understand. Please explain why more transfusions would fool the passport. More net withdrawals and net infusions would mean more peaks and valleys in Hb and retics. More transfusions because you're playing the zero-sum game* that is withdrawal/infusion is just a way of getting around the short storage time problem. Athletes freeze blood so they wont have to do the old switch-a-roo every 4(?) weeks or whatever it is.
ingsve explained it pretty well. The test referenced by the OP looks at changes in RBCs that are stored frozen. If you have periodic withdrawals/transfusions, you don't need to freeze the cells, you store them at refrigerated temps. Hence the changes that occur in RBCs when frozen don't necessarily occur. As I noted earlier, cells stored at refrigerated temperatures will also undergo changes, but probably not as dramatic, and as easily detectable, as those in frozen cells.
Also, this would most likely be a standalone test, not part of the passport. Just like the current test for homologous transfusion--using blood of another individual--is a standalone test. Of course, riders are also being tested by the passport while this is going on, but all these withdrawals/transfusions, if done carefully, don't affect basic blood values much. Usually a withdrawal is followed by a transfusion, which keeps HT/Hb and retics at about the same value. Before a race, there will only a transfusion, or at the least, a withdrawal followed by a transfusion of a greater amount than was withdrawn. This is where riders use techniques like saline infusion to lower HT and EPO to raise retics.
So far they can detect changes in lab samples but it's not clear if they have even tested reinfused blood yet which is a critical step.
Yes, they certainly need to do that, but most likely most of the changes that occur in the cells upon freezing would not be reversed upon transfusion. Transfused cells have a half-life of about four months, so there would be plenty of them in circulation during the time frame in which testing would occur.
Basso re-infused rbc and plasma separately prior to the 2006 Giro.
Yes, this is thought to be a common practice now. Riders do separate cells and plasma, which requires a centrifuge. But they store them at refrigerated temperatures, so it is not necessary to treat the cells with glycerol and freeze them by the special process required for long-term storage. This I think is fairly expensive if you are going to be sure you do it right. And as Tyler's book graphically notes, you don't want to infuse damaged cells.