Quality of red blood cells washed using an automated cell processor with and without irradiation.
Author(s): Hansen AL, Turner TR, Yi QL, Acker JP
Publication: Transfusion, 2014, Vol. 54(6), Page 1585-94
PubMed ID: 24224608 PubMed Review Paper? No
Purpose of Paper
The purpose of this paper was to determine the effects of washing method, irradiation, and refrigerated storage on markers of red blood cell (RBC) quality.
Conclusion of Paper
Storage of RBCs at 4 degrees C for 48 h after irradiation led to increases in hemolysis and supernatant potassium. On day 7 post-wash, units produced by the buffy coat method had lower volumes, hemoglobin (Hb) content, hematocrit (Hct), and extracellular potassium levels than those produced by the whole blood filtration method, regardless of irradiation on day 5 or not. RBC recovery and volumes were higher and Hct was lower in RBCs washed using the ACP-rather than the COBE machine, but hemolysis and Hb content were comparable.
Studies
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Study Purpose
The purpose of this study was to determine the effects of RBC isolation method, automated washing method, irradiation timing, and post-wash and post-irradiation refrigerated storage duration on markers of RBC quality. Citrate phosphate dextrose (CPD) whole blood was processed into leukoreduced RBCs in saline adenine glucose mannitol (SAGM) using the buffy coat method or filtration. RBCs were stored for 14 days before automated washing, gamma-irradiated on day 1, 4, 5 or 7 post-wash, and assayed on day 5, 6, 7 or 8, or they were left unirradiated. RBC acceptance criteria were defined as hemoglobin (Hb) levels >40 g/unit in 90% of units and no units less than 35 g/unit, hematocrit of <0.80 L/L in all units, hemolysis <0.8% in 98% of units with 95% confidence, and ATP >2.7 umol/g Hb in all units.
Summary of Findings:
Specimens irradiated on either days 1 or 4 post-wash had elevated rates of hemolysis (p<0.03) and supernatant potassium (p<0.01) when stored for 48 h after irradiation prior to analysis, but specimens that were irradiated on day 5 or 7 met red blood cell acceptance criteria, including those for hemolysis and supernatant potassium, after a maximum additional refrigerated storage of 2 or 0 days, respectively. On day 8 post wash, RBCs that were irradiated on day 5 had higher hemolysis rates and extracellular potassium levels than units that were just washed (p<0.01). Based on these findings, the authors recommend a maximum of 7 days of refrigerated storage post-wash or 2 days post-irradiation for RBCs. While all units irradiated on day 5 post-wash met the RBC acceptance criteria, these units as well as unirradiated units produced by the buffy coat method had lower volumes, Hb content, Hct, and extracellular potassium than those produced by the whole blood filtration method when measured on day 7 of post-wash storage (p<0.01, all). Compared to levels measured on day 5 of pre-wash storage, RBCs stored 8 days post-wash had similar supernatant potassium levels, but elevated hemolysis levels (p<0.01) which were comparable to those in unwashed RBCs stored for 42 days. RBC recovery rates and volumes were higher and Hct was lower in ACP-washed RBCs than COBE washed RBCs (p<0.01, all), but hemolysis and Hb content were comparable.
Biospecimens
Preservative Types
- Other Preservative
Diagnoses:
- Not specified
Platform:
Analyte Technology Platform Protein Hematology/ auto analyzer Electrolyte/Metal Clinical chemistry/auto analyzer Cell count/volume Hematology/ auto analyzer Small molecule Clinical chemistry/auto analyzer Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Storage Storage duration 1 day
4 days
5 days
7 days
8 days
14 days
42 days
Biospecimen Aliquots and Components Blood processing method Irradiated
Not irradiated
RBC isolated by buffy coat method
RBC isolated by filtration
Washed
Unwashed
Analyte Extraction and Purification Washing COBE 2991 washed
ACP 215 washed
Unwashed