Can BigBoat or someone else explain this to me please??

[Colonel]

with regards to blood doping there is one thing I do not understand and please dont bash me for it:

I understand that you take out for example 2L of blood, store it for later use. Then I understand your body re-produces the 2L that was extracted to get your blood levels "Normal" again.

Then you go and "top up" and you feel all good etc etc. But say over the TDF you put that 2L back in your system isnt your body overloaded with blood and the more you do it the more it is "overloaded" or does the body expel the excess blood somehow?

 

[elapid]

No, your body will not be overloaded. As a rough guide, your blood volume is approximately 10% of your body weight. As an example, if you are 80 kg then your blood volume is approximately 8 liters. An additional 25% of your blood volume will not overhydrate or cause any other problems. The promised land is that the autologous blood transfusion provides additional oxygen carrying capacity (because of more red blood cells) which in turn means better performance, particularly in the mountains.

As a side note, I am not sure what volumes are being taken and stored, but 2 liters sounds like a lot. From a physiological standpoint, 10% of your blood volume is no problems, 20% is pushing the limits, and 25% will push you over the limits. I would have thought it would be safer to withdraw smaller amounts (< 1 liter), perhaps more frequently, than a single larger donation.

 

[Gav1983]

I'm no expert on this, but I'm sure you are right, the blood would not be taken out in volumes as high as two litres at a time.

When it comes to the usage of the blood, I believe it's not the actual full 2 litres of blood that is used; it is just the extracted oxygen carrying red cells, which are separated from the blood using a centrifuge.

 

[Colonel]

Ok thanks alot guys and sorry for the 2L part I was just using an example there of.

 

[RdBiker]

Ok thanks alot guys and sorry for the 2L part I was just using an example there of.

Kohl inserted two litres of blood on three separate occasions during one Tour de France.

 

[BigBoat]

400cc of pure red cells with the plasma spun off will give a good boost in hematocrit. (2/5 of a liter.) Kohl did 600 cc refills ( 6/10 of a liter.) This is not much a a shift in total volume really.

too much blood happens with congestive heart failure though! With too much volume the lungs can become overloaded causing lack of air (shortness of breath) and eventually death. (the heart cannot pump blood throughout the body and you get fluid retention. The fluid retention ends up as volume.)

When you lose blood the body immediately replaces it with plasma volume, so you will hematocrit reading will drop since you lost red cells but then your body replaced the lost blood volume with plasma. Thats why the pro cyclist "train off" blood so their crit reading will be lower and they pass their medical "exams."

You can actually refill on saline too and your crit reading will drop (but oxygen carrying capacity doesnt since you still have the same number of red cells but more fluid.) Thing is... Having an extra liter or 2 of fluid in the body would totally SUCK if your climbing mountains and racing hard. lol

 

[Murray]

It's not volume of blood riders are trying to increase, it is the concentration of red blood cells (measured as hematocrit). As was already said, they spin down the extracted blood to a high hematocrit, wait until their body normalizes, then they reinject the high hematocrit blood to achieve supranormal hematocrit, increasing their oxygen carrying capacity.

Don't try this at home.

Murray

 

[BigBoat]

Total red cells is what improves 02 carrying capacity. The concentration of red cells can be less if they are hemodiluting though. You can go from say 56% to 49% with some "extra bags" lol.

 

[Anonymous]

Kohl inserted two litres of blood on three separate occasions during one Tour de France.

6 litres total.. um.. are you sure about that...

what is a litre anyway.. we have our blood over here in pints.. :?

i understand the whole blood doping thing, and how it works, so when vinny was done for full transfusion what was he up to?

 

[BigBoat]

6 litres total.. um.. are you sure about that...

what is a litre anyway.. we have our blood over here in pints.. :?

i understand the whole blood doping thing, and how it works, so when vinny was done for full transfusion what was he up to?

I think Kohl just took three 650cc refills... 2 liters.

Vinokourov? The centrifuge they used was probably dirty (had some of his teamate's blood left in.) All it takes is a little.

 

[Murray]

Total red cells is what improves 02 carrying capacity.

Actually, that is not true... oxygen carrying capacity is dependent on hemoglobin concentration (or hematocrit), not total red cells.

Murray

 

[elapid]

One pint = approximately 600 ml.

The overhydration issue, which is not really pertinent to this discussion anyway, is only a concern if the recipient has either heart or kidney disease. If both of these organs have normal to near-normal function, then excess intravascular fluids are quickly urinated to restore normal hydration levels. As BigBoat said, overhydration becomes a concern if the heart or kidneys are diseased and cannot handle the volume overload.

However, this is unlikely to be an issue for cyclists. As BigBoat and others have pointed out, the most important factor in autologous transfusions is red blood cells. There are various techniques to prepare blood transfusions, the most common being as either whole blood or spinning down the blood, removing the plasma, and leaving just the red blood cells (simplified). The latter is called packed red blood cells. Packed red blood cells would be more beneficial than whole blood because they are concentrated oxygen carriers, not diluted out with plasma and other components. Packed red blood cells are a much smaller volume than whole blood and therefore overhydration is very unlikely to be a problem following transfusion.

 

[elapid]

Actually, that is not true... oxygen carrying capacity is dependent on hemoglobin concentration (or hematocrit), not total red cells.

Your are correct and incorrect. Oxygen carrying capacity is dependent on hemoglobin concentration, but hemoglobin concentration is not the same as hematocrit. Hematocrit = packed red cell volume. As BigBoat pointed out, you can have the same total red cell count (and hemoglobin concentration), but your hematocrit will be increased if you are dehydrated and decreased with overhydration.

Hemoglobin is the oxygen-carrying molecule on red blood cells, and makes up 90% of a red blood cell volume. Hence, hemoglobin concentration is dependent on total red blood cells and both are indicative of oxygen carrying capacity, but not necessarily hematocrit.

 

[Susan Westemeyer]

AS to how much blood Kohl transfused at the Tour, let me quote myself:

"The Austrian's manager Stefan Matschiner brought two litres of blood and centrifuge to the Tour, Kohl said. He went to Matschiner's hotel room three times to receive transfusions of half a litre."

Susan

 

[ElChingon]

AS to how much blood Kohl transfused at the Tour, let me quote myself:

"The Austrian's manager Stefan Matschiner brought two litres of blood and centrifuge to the Tour, Kohl said. He went to Matschiner's hotel room three times to receive transfusions of half a litre."

Susan

So where did that info come from?

 

[Susan Westemeyer]

So where did that info come from?

That is what Kohl said at his press conference on Monday, and the quote is from my story on CN.

Edit to add link: http://www.cyclingnews.com/news.php?id=news/2009/may09/may26news2


Susan

 

[Murray]

...you can have the same total red cell count (and hemoglobin concentration), but your hematocrit will be increased if you are dehydrated and decreased with overhydration.

Hemoglobin concentration changes with hydration status along with hematocrit. Total number of red cells in your body does not change with hydration but also has nothing to do with oxygen delivery capacity.

You are right that hemoglobin concentration and hematocrit are not the same but we assume that athletes have a normal MCV (mean cell volume) and therefore hemoglobin concentration and hematocrit will be proportional.

Murray

 

[Advancedone]

The thing I have wondered about is the fact that blood transfusions don't increase oxygen carrying ability of the stored blood for a number of days, and if the blood has been stored for to long can even hamper oxygen release.

Here's a quote I found:

"Blood in cold storage contains glucose as a potential substrate for ATP production, but the glycolytic enzymes do not work well in the cold. Remember, DPG is produced as a byproduct of glycolysis. Thus, DPG levels decrease in refrigerated (stored) blood. Thus, if refrigerated whole blood is stored for too long, it becomes less efficient at O2 unloading, because it contains less DPG!

DPG decreases so much by the time the blood is 10 days old that the Hb affinity for O2 is actually increased such that less O2 is released from Hb which has been refrigerated for 10 days. For this reason, refrigerated blood is not normally stored beyond 21 days; if refrigerated blood older than 21 days is transfused, it picks up O2 at the lung but will not release the O2 at the tissues. Transfusion of blood older than 21 days actually impairs O2 transfer to the tissues. When older refrigerated blood is returned to the body, the levels of DPG present in the blood will gradually increase, but the initial decline in O2 carrying capacity following transfusion should be considered potentially dangerous. Blood which is to be used for planned autologous transfusions (planned surgeries, for example), should be frozen if it will not be used within a few weeks... and must be frozen if it is to be stored for 42 days or more. While improving cell freezing technologies (development of less toxic cryoprotectants) allows cells to be frozen indefinitely, frozen blood is generally used within 1 year, but is readily frozen for 10 years or more.

Remember, DPG levels are increased in people living at high elevations, such that the efficiency of O2 unloading from their Hb at the tissues is increased."

I wonder if this still applies to packed red blood cells. As it takes 24-48 hours for the transfused blood to reach full O2 carrying ability they would need to be timed right or it would seem that Hemopure or a similar product would be more useful.

 

[elapid]

Hemoglobin concentration changes with hydration status along with hematocrit. Total number of red cells in your body does not change with hydration but also has nothing to do with oxygen delivery capacity.

You probably know better than I, but I am not so sure about this. If red blood cells carry hemoglobin and hemoglobin is responsible for the oxygen carrying capacity, then wouldn't the number of total red cells be proportional to the total hemoglobin? And wouldn't this mean the total number of red cells determines (albeit indirectly through total hemoglobin) oxygen carrying capacity?

For instance, Laura Dean in "Blood Groups and Red Cell Antigens" states "In humans, as in all mammals, the mature RBC lacks a nucleus. This allows the cell more room to store hemoglobin, the oxygen-binding protein, enabling the RBC to transport more oxygen". As a corollary, anemia is defined by SM Cotter in her textbook Hematology as a "decrease in the total red blood cell mass to a point where oxygen-carrying capacity of the blood is compromised."

Or is mean corpuscular hemoglobin concentration more important for determining oxygen-carrying capacity?

You are right that hemoglobin concentration and hematocrit are not the same but we assume that athletes have a normal MCV (mean cell volume) and therefore hemoglobin concentration and hematocrit will be proportional.

Correct

 

[BigBoat]

They minimize red cell death by storing the blood properly, thawing it properly and "cleaning" it out properly... And if there's cell death they just use more until crit is jacked.

You see saline, volume expanders in the morning for the "weigh in" do not lower the oxygen carrying capacity of the blood as long as the red cells are still there > eventually the extra volume will be pis$ed off during the stage. Many are probably are racing under 50% though.

 

[RdBiker]

6 litres total.. um.. are you sure about that...

what is a litre anyway.. we have our blood over here in pints.. :?

i understand the whole blood doping thing, and how it works, so when vinny was done for full transfusion what was he up to?

Sorry meant to say two litres in total, so 660ml three times.

 

[BigBoat]

They might actually have to use like Desmospray to keep the fluids in for the morning controls, but eventually all the fluid will be gone and they crit will go back up for racing. You know what I'm sayin' Murray? Their not going to stay hemodiluted for long.

 

[Alpe d'Huez]

They might actually have to use like Desmospray to keep the fluids in for the morning controls, but eventually all the fluid will be gone and they crit will go back up for racing. You know what I'm sayin' Murray? Their not going to stay hemodiluted for long.

But isn't that how perfluorocarbon emulsions and hemoglobin based oxygen carriers work? I mean, not directly, but in that you get the boost without having to dilute as they don't raise the crit much. No?

 

[BigBoat]

They are using excess fluid to lower red cell concentration after blood doping, but when they pee out the extra water their red cell concentration goes up. (hematocrit reading will rise.) The top dogs (15 minutes after the finish) should all have jacked crit readings 50-55%.

With hemopure the cells are dead. I dont think hemopure/ oxyglobin works all that well. There is certain stuff out there not listed on the banned list that works very "Vell" though. Things that Ferrari would know about.

Actovegin (free protein calf blood extract) helps a bit with 02 transport, oxidizing metabolism and energy to the cells is boosted. Acto is a good PED from what people say about it.

http://www.cuttingedgemuscle.com/Forum/showthread.php?s=&threadid=21479

 

[elapid]

A very good objective and scientific summary of the effects of blood transfusions, EPO and other substances can be found in the textbook
"Performance Enhancing Substances in Sport and Exercise". An online version can be seen at: http://books.google.com/books?id=nPJaTdp47mcC&pg=PA89&lpg=PA89&dq=athletes+with+positive+tests+for+HCG+having+testicular+cancer&source=bl&ots=HFvA7Smhss&sig=FFdBaKkS63sxnfaXKCK7uRJ8z0o&hl=en&ei=qs0fSsvhBZLaMbjIyaUJ&sa=X&oi=book_result&ct=result&resnum=2#PPA94,M1

See pp. 93-99 for blood transfusions and 101-108 for EPO.