NIH, National Cancer Institute, Division of Cancer Treatment and Diagnosis (DCTD) NIH - National Institutes of Health National Cancer Institute DCTD - Division of Cancer Treatment and Diagnosis

Manufacture of red cells in additive solution from whole blood refrigerated for 5 days or remanufactured from red cells stored in plasma.

Author(s): Wiltshire M, Cardigan R, Thomas S

Publication: Transfus Med, 2010, Vol. 20, Page 383-91

PubMed ID: 20681977 PubMed Review Paper? No

Purpose of Paper

The purpose of this paper was to determine the effects of duration of storage of leukoreduced blood or red blood cell concentrates (RCC) in citrate phosphate dextrose (CPD) plasma or CPD adenine (CPDA-1) plasma before storage in saline adenine glucose mannitol (SAGM) and the effects of irradiation on markers of RCC quality.

Conclusion of Paper

Initially, RCC refrigerated for 5 or 6 days in CPD prior to placement in SAGM had comparable hematocrit but lower volume and hemoglobin levels compared to RCC produced in SAGM. After additional storage in SAGM, some differences in hemolysis rates and supernatant potassium levels were noted between specimens produced in CPD before storage in SAGM and those produced in SAGM. Irradiation of RCC, stored in CPD for 5 days before placement in SAGM, led to a lower hematocrit and higher rates of hemolysis during storage. Refrigerated storage of leukodepleted blood prior to production of RCC in SAGM had little to no effects on any of the markers of RCC quality compared to RCC produced in SAGM on day 0. RCC in CPD and CPDA-1 had comparable hemolyisis rates, but supernatant potassium levels increased and adenosine triphosphate (ATP) levels decreased significantly faster with refrigerated storage of RCC in CPD than CPDA-1, and 2,3-diphosphoglycerate (2,3-DPG) levels were lower in RCC stored in CPDA-1 than CPD.

Studies

  1. Study Purpose

    The purpose of this study was to determine the effects of refrigerated storage of RCC in CPD for 5 or 6 days prior to refrigerated storage in SAGM and subsequent irradiation of RCC on day 14 on markers of RCC quality. Values were compared to published reference values for RCC stored in SAGM from day 0. The storage duration is the total storage duration such that value for days 1-5 or 6 are for RCC in CPD.

    Summary of Findings:

    RCC stored in CPD plasma for 5 or 6 days before replacement of the storage solution with SAGM had comparable hematocrit but slightly lower volume and hemoglobin content than published reference data based on storage of RCC in SAGM from day 0 on. Hemolysis rates increased with refrigerated storage of RCC transferred to SAGM on day 5 or 6, but rates were only significantly higher than reference rates in specimens transferred to SAGM on day 5 and stored for 35 or 42 days (p<0.05, and p<0.001, respectively). Supernatant potassium levels also increased with refrigerated storage, but after 35 and 42 days, potassium levels were lower in specimens stored in CPD until day 6 and then placed into SAGM than reference specimens stored in SAGM the entire time (p<0.001, both). ATP and 2,3-DPG levels decreased during refrigerated storage of RCC, regardless of whether or not they were stored in CPD prior to storage in SAGM. The volume and hemoglobin content of specimens transferred to SAGM on day 5 were unaffected by irradiation on day 14, but the hematocrit was lower in irradiated RCC than non-irradiated RCC (p<0.05). Hemolysis increased during storage of irradiated specimens, and by day 28 (14 days post-irradiation), all irradiated RCC had hemolysis levels >0.8% compared to only 15% of non-irradiated specimens transferred to SAGM on day 5 or 6 having hemolysis levels >0.8%.

    Biospecimens
    Preservative Types
    • Other Preservative
    Diagnoses:
    • Normal
    Platform:
    AnalyteTechnology Platform
    Cell count/volume Hematology/ auto analyzer
    Cell count/volume Spectrophotometry
    Electrolyte/Metal Clinical chemistry/auto analyzer
    Small molecule Clinical chemistry/auto analyzer
    Small molecule Spectrophotometry
    Pre-analytical Factors:
    ClassificationPre-analytical FactorValue(s)
    Storage Short-term storage solution CPD
    SAGM
    Storage Storage duration 1 day
    2 days
    5 days
    6 days
    7 days
    14 days
    28 days
    35 days
    42 days
    Biospecimen Aliquots and Components Blood processing method Not irradiated
    Irradiated
  2. Study Purpose

    The purpose of this study was to determine the effects of refrigerated storage of leukodepleted whole blood for 5 days prior production of RCC in SAGM and on markers of RCC quality. Values were compared to published reference values for RCC stored in SAGM from day 0.

    Summary of Findings:

    When RCC were produced in SAGM after refrigeration of leukodepleted whole blood for 5 days at 4 degrees C, the volume, hematocrit and hemoglobin content were comparable to published reference values based on RCC stored in SAGM from day 0 (no prior storage of leukodepleted whole blood). After 42 days of storage in SAGM, RCC from leukoreduced blood, previously stored for 5 days at 4 degrees C, had similar hemolysis rates, 2,3-DPG levels and similar or lower supernatant potassium levels compared to published reference values. ATP levels in RCC from leukoreduced blood that was previously stored for 5 days at 4 degrees C were initially lower than published reference values, but by day 42 of storage, levels were comparable.

    Biospecimens
    Preservative Types
    • Other Preservative
    Diagnoses:
    • Normal
    Platform:
    AnalyteTechnology Platform
    Cell count/volume Hematology/ auto analyzer
    Cell count/volume Spectrophotometry
    Electrolyte/Metal Clinical chemistry/auto analyzer
    Small molecule Clinical chemistry/auto analyzer
    Small molecule Spectrophotometry
    Pre-analytical Factors:
    ClassificationPre-analytical FactorValue(s)
    Storage Storage duration 1 day
    2 days
    5 days
    6 days
    7 days
    14 days
    28 days
    35 days
    42 days
    Biospecimen Aliquots and Components Blood and blood products Leukocyte reduced blood
    Red blood cells
  3. Study Purpose

    The purpose of this study was to determine the effects of production of RCC in CPD versus CPDA-1 and refrigerated storage duration on markers of RCC quality. RCC in CPD were stored for up to 28 days, while RCC in CPDA-1 were stored for up to 35 days.

    Summary of Findings:

    RCC from whole blood collected into CPD or CPDA-1 met the specifications for volume and the original guideline of a hematocrit between 0.50 and 0.60, but only 25% of specimens met the more stringent requirement of a hematocrit between 0.50-0.55. Hemolysis rates met guidelines and were comparable between specimens collected in CPD and CPDA-1. Supernatant potassium levels increased, and ATP levels decreased with refrigerated storage of RCC in CPD and CPDA-1, but the rate of change was significantly greater when units were stored in CPD than CPDA-1 (p<0.05, both). 2,3-DPG levels were lower in RCC stored in CPDA-1 than CPD (p<0.01).

    Biospecimens
    Preservative Types
    • Other Preservative
    Diagnoses:
    • Normal
    Platform:
    AnalyteTechnology Platform
    Cell count/volume Hematology/ auto analyzer
    Cell count/volume Spectrophotometry
    Electrolyte/Metal Clinical chemistry/auto analyzer
    Small molecule Clinical chemistry/auto analyzer
    Small molecule Spectrophotometry
    Pre-analytical Factors:
    ClassificationPre-analytical FactorValue(s)
    Storage Storage duration 1 day
    2 days
    6 days
    7 days
    14 days
    28 days
    35 days
    Biospecimen Acquisition Anticoagulant Citrate phosphate dextrose adenine 1
    Citrate-phosphate-dextrose

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