Laser-assisted optical rotational cell analyser (L.O.R.C.A.); II. Red blood cell deformability: Elongation index versus cell transit time

Red blood cell deformability was measured under normal and experimental conditions with the Laser-assisted Optical Rotational Cell Analyser (LORCA). Results were compared to simultaneously performed filtration measurements using the Cell Transit Analyser (CTA). The deformability parameters of the two methods were Elongation Index (EI) and mean Cell Transit Time (CIT), respectively. Aside from instrumental and intra-individual reproducibility, normal values, the effect of sample aging and of changing medium osmolality are reported. Furthermore, the respective sensitivities were determined using red blood cells with slightly impaired deformability. Both heat treatment and incubation in the presence of low concentrations of glutaraldehyde are used to manipulate the deformability of the entire red cell population. It is concluded that minor defects in red blood cell deformability are detected more easily by the laser technique than by filtration. Even when the absolute differences in EI are small, they can be significant due to the very high reproducibility of the ektacytometric technique. Differentiation between a decreased deformability of the entire RBC population and the presence of a small (i.e., 5% or higher) subpopulation of rigid cells can be achieved with the LORCA by combining the measured EI-values with visual inspection of the diffraction pattern. Finally, no significant correlation was found between the results of both techniques applied to blood from 525 patients with various diseases.