Background: Blood transfusions are banned by the World Anti-Doping Agency as a form of
“blood doping”. A method of detection of homologous blood transfusion (HBT) has been implemented
by the accredited anti-doping laboratories worldwide; however, no internationally recognized method
has been finalized so far for the direct detection of autologous blood transfusions, which can at present
be revealed only by targeted longitudinal profiling of key blood parameters.
Methods: The present article reports the results of an investigation aimed to pre-select potential biomarkers
of blood aging and storage that can be measured to identify the presence in the sample of reinfused
blood. Microparticles from platelets and erythrocytes, erythrocytes size and density, annexin V
(as a marker of phosphatidylserine externalization), and the membrane surface antigens CD 55 and CD
59, were specifically considered as potential biomarkers and measured by flow cytofluorimetric techniques.
Results and Conclusion: Our results indicate that the parameters more strongly affected by the ex vivo
storage of whole blood are erythrocytes size and density, annexin V and microparticles. Although the
real diagnostic value of the proposed biomarkers shall obviously be confirmed by further studies carried
out on blood samples collected after an actual autologous blood transfusion, these results appear
very encouraging towards the development of a direct method for detecting autologous blood transfusion
in sport doping.