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The in vitro quality of washed, prestorage leucocyte-depleted red blood cell concentrates
V Weisbach1, W Riego, E Strasser
1Department of Transfusion Medicine and Haemostaseology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany. Volker.Weisbach@trans.imed.uni-erlangen.de
Insights
Washing red blood cell concentrates (RCCs) significantly reduces 2,3-diphosphoglycerate (2,3-DPG), impacting erythrocyte quality. This loss is more pronounced in older RCCs and during post-wash storage, potentially affecting neonatal transfusions.
Area of Science:
- Transfusion Medicine
- Blood Banking
- Red Blood Cell Physiology
Background:
- Limited data exists on the quality of washed prestorage leucocyte-depleted red blood cell concentrates (RCCs).
- Washing is a procedure used to remove plasma components from red blood cells.
Purpose of the Study:
- To evaluate the quality of washed red blood cell concentrates (RCCs) stored in additive solution (SAG-M).
- To assess the impact of washing on key erythrocyte metabolites and parameters.
Main Methods:
- Five groups of RCCs (2-5 days or 11-15 days old) were washed using saline, SAG-M, or 5% albumin.
- Measurements included ATP, 2,3-DPG, hemolysis, cell count, electrolytes, pH, gases, and lactate before and after washing, and during 6-hour post-wash storage at 4°C or room temperature.
Main Results:
- Erythrocyte ATP content slightly increased post-washing.
- A significant decrease in 2,3-diphosphoglycerate (2,3-DPG) was observed, ranging from 15-40% depending on RCC age and washing conditions.
- Further 2,3-DPG loss occurred during post-wash storage, especially at room temperature and in older RCCs.
Conclusions:
- Washing RCCs stored in SAG-M leads to substantial loss of erythrocyte 2,3-DPG, particularly in older units.
- This loss is exacerbated during post-wash storage, even at 4°C.
- The decline in erythrocyte quality may negate the benefits of washed SAG-M RCCs in massive neonatal transfusions.
Background And Objectives:
No data are currently available on the quality of washed prestorage leucocyte-depleted red blood cell concentrates (RCCs).
Materials And Methods:
Five groups of RCCs stored in additive solution (SAG-M) were washed. The groups differed in the age of RCCs (2-5 days or 11-15 days), the temperature during the washing procedure and a 6-h storage period (4 degrees C or room temperature) and the washing solution (saline, SAG-M or 5% albumin). We measured ATP, 2,3-diphosphoglycerate (2,3-DPG), haemolysis, blood cell count, Na(+), K(+), pH, pO(2), pCO(2) and lactate, before and after the washing procedure and hourly during the 6-h postwash storage period.
Results:
The erythrocyte ATP content increased by 2-13%, relative to the baseline value, during the washing procedure. The 2,3-DPG level decreased by 15-35% in 2-6-day-old RCCs and by 30-40% in 11-15-day-old RCCs (relative to baseline values) during the washing procedure. In RCCs that were washed and stored at room temperature, and in 2-week-old RCCs, a further decrease in 2,3-DPG of up to 40%, relative to the baseline value, was observed during the 6-h postwash time-period.
Conclusions:
Washing of RCCs stored in SAG-M results in a considerable, significant loss of erythrocyte 2,3-DPG, especially in older RCCs. This loss increases in during a 6-h storage period postwash, even at 4 degrees C. This loss of erythrocyte quality might well outweigh the benefits of washed SAG-M RCCs during massive transfusion in neonates.
