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Objectives: To determine the extent of RBC sublethal injury in male donor units as measured by both the mechanical fragility index (MFI) and percentage hemolysis after RBCs underwent leukoreduction (LR), irradiation (IRRAD), and washing. Background: RBCs frequently undergo post-collection processing to meet certain recipient's special needs. The extent of hemolysis and sublethal injury following these interventions has not been fully characterised. Methods: Eight to ten day old male, AS-5 RBCs underwent either LR, IRRAD or washing. A control group of male, AS-5 RBCs were unmanipulated. The MFI, percent hemolysis, and plasma free hemoglobin (PFHb) were measured immediately after manipulation and, for a series of irradiated RBCs, 28 days after irradiation (IRRAD28). Results: The MFI of the washed units was significantly higher than unmanipulated, LR, IRRAD, IRRAD28 units (P < 0·0001). The percent hemolysis was highest in the IRRAD28 units (1·4%) followed by the washed units (0·74%); the other three units demonstrated significantly less hemolysis (P < 0·0001). The largest mean total amount of PFHb per unit was found in the IRRAD28 units (500·5 mg/unit) followed by the washed units (149·8 mg/unit); the mean total amount of PFHb in the three other types of units was significantly less than that found in both the IRRAD28 and washed units (P at least < 0·001). Conclusion: There is a significant quantity of PFHb in IRRAD28 RBC units, and potentially in washed allogeneic RBC units. Clinical correlation is required to determine if this quantity of PFHb and the transfusion of potentially fragile RBCs causes adverse events.
Department of Pathology, University of Pittsburgh Medical Center The Institute for Transfusion Medicine Department of Anesthesiology, Magee-Womens Hospital of University of Pittsburgh
This article was published in the following journal.
Name: Transfusion medicine (Oxford, England)
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