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Lymphocyte subsets in inline filtered packed red blood cell units: comparison between low and high spin procedures
Luca Mascaretti1, Laura Baggi, Mariarosa Riva
1Blood Transfusion Center, Azienda Ospedaliera San Gerardo, Servizio Immunotrasfusionale, Monza, Italy. l.mascaretti@hsgerardo.org
Summary
Filtration of packed red blood cells (PRC) significantly reduces white blood cells (WBCs). While some WBCs remain after filtration in Group A, Group B filtration effectively removes most lymphocytes, impacting subset analysis.
Area of Science:
- Blood banking and transfusion medicine
- Immunology
- Cellular analysis
Background:
- Packed red blood cell (PRC) units can contain significant numbers of white blood cells (WBCs).
- Filtration systems are used to reduce WBC contamination in blood products.
- Different preparation methods for PRC units may affect initial WBC content.
Purpose of the Study:
- To evaluate the efficacy of the Pall Leukotrap RC inline filter system in reducing WBCs and lymphocyte subsets in PRC units.
- To compare the impact of two different PRC preparation methods (low spin vs. high spin) on filter performance.
Main Methods:
- 20 PRC units were analyzed before and after filtration using the Pall Leukotrap RC system.
- Units were divided into Group A (low spin, platelet-rich plasma removal) and Group B (high spin, plasma and buffy-coat removal).
- Flow cytometry was used for WBC enumeration and phenotype analysis of lymphocyte subsets (CD3+, CD4+, CD8+, CD19+).
Main Results:
- Prefiltration WBC counts were significantly higher in Group A (2.08 x 10^9) compared to Group B (0.8 x 10^9).
- Post-filtration, WBC counts were above the limit of detection in 5 Group A units (median 25.59 x 10^3) and 3 Group B units (median 3.08 x 10^3).
- Lymphocyte subsets (CD3+, CD4+, CD8+) were assessable in 20-40% of Group A units, but mostly below the limit of detection in Group B units. Post-filtration CD19+ lymphocytes were below the limit of detection in all units.
Conclusions:
- Inline filtration effectively reduces WBCs in PRC units, with Group B preparation showing a greater reduction.
- The filtration process, particularly with Group B preparation, significantly lowers lymphocyte subsets below the limit of detection, potentially hindering immunological studies.
- Further optimization may be needed for preserving specific lymphocyte subsets if required for transfusion purposes.