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[Hyperkalemia after irradiated blood transfusion]
Y Fukuoka1, T Ishiyama, T Oguchi
1Department of Anesthesiology, Yamanashi Medical University.
Masui. the Japanese Journal of Anesthesiology
|March 24, 1999
Summary
Transfusing irradiated red blood cells (RBCs) can increase potassium levels, potentially causing hyperkalemia. Careful monitoring and management are crucial during and after transfusions of stored, irradiated RBCs.
Area of Science:
- Transfusion Medicine
- Anesthesiology
- Clinical Biochemistry
Background:
- Patient underwent hepatectomy and colectomy under general anesthesia with epidural block.
- Received transfusions of irradiated Red Blood Cell-Microaggregate-Free (RBC-MAP) during surgery.
Observation:
- Following transfusion of irradiated RBC-MAP, the patient exhibited elevated T waves on ECG.
- Serum potassium levels rose to 5.4 mmol/L, indicating hyperkalemia.
Findings:
- Hyperkalemia resolved after stopping RBC-MAP transfusion and administering calcium gluconate, with potassium decreasing to 4.3 mmol/L.
- A significant portion of transfused RBC-MAP (8 out of 10 units) had been stored for over a week post-irradiation.
- Elevated potassium concentrations in the plasma of stored, irradiated RBC-MAP are suspected to induce hyperkalemia.
Implications:
- Irradiation of blood products, while preventing graft-versus-host disease, increases potassium levels in RBC-MAP.
- Clinicians must be aware of the risk of hyperkalemia associated with stored, irradiated RBC-MAP transfusions.
- Close monitoring of serum potassium and ECG is recommended for patients receiving these blood products.