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Viability of AS-3 and SAG-M red cells stored in plastic syringes for pediatric transfusion
Linda Podlosky1, Amanda Poirier, Susan Nahirniak
1The Capital Health/Stollery Children's and University of Alberta Hospitals, Edmonton, Alberta, Canada. linda.podlosky@capitalhealth.ca
Insights
Storing pediatric red blood cells (RBCs) in plastic syringes for up to 24 hours is as safe and effective as using transfer bags. This finding supports the use of syringes for small-volume transfusions in pediatric patients.
Area of Science:
- Transfusion Medicine
- Pediatric Hematology
Background:
- Pediatric patients often need small-volume transfusions, requiring the splitting of red blood cell (RBC) units.
- Current practice involves storing aliquoted RBCs in pediatric blood bags or plastic syringes.
- Limited evidence exists on the safety and efficacy of RBCs stored in plastic syringes.
Purpose of the Study:
- To evaluate the safety and efficacy of pediatric red blood cells (RBCs) stored in plastic syringes compared to transfer bags.
- To assess the impact of irradiation and storage conditions on RBC viability in aliquots.
Main Methods:
- Donor RBC units (SAG-M and AS-3) were aliquoted into transfer bags and plastic syringes.
- Aliquots were stored at 4°C or room temperature (RT) and half were irradiated (25 Gy).
- RBCs were analyzed for adenosine triphosphate, hemolysis, hematocrit, pH, lactate dehydrogenase, electrolytes, and indices at 0, 4, and 24 hours.
Main Results:
- No significant differences in RBC viability or function were observed between irradiated and non-irradiated aliquots.
- Storage temperature (4°C vs. RT) did not significantly impact RBC quality.
- No significant differences were found between RBCs stored in transfer bags versus plastic syringes.
Conclusions:
- Storage of aliquoted RBCs in plastic syringes for up to 24 hours does not adversely affect cellular function or viability compared to transfer bags.
- Irradiation and storage conditions showed expected, non-significant changes in in vitro variables.
- Aliquoted RBCs stored in syringes are safe for transfusion to pediatric patients.
Background:
Pediatric patients may require small-volume transfusions necessitating splitting of red cell (RBC) units. This process usually involves temporary storage of aliquots in pediatric blood bags or, in some cases, plastic syringes, until they are transfused. While many studies have been published on the efficacy of storage in blood bags, there is little evidence to show that RBCs are safe and effective for transfusion after separation into plastic syringe aliquots.
Study Design And Methods:
Donor RBC units, stored in either SAG-M (n = 10) or AS-3 additive (n = 11), were split into transfer bags and plastic syringes and stored at either 4 degrees C or room temperature (RT). Half of the aliquots were also irradiated at 25 Gy. RBCs were monitored after 0, 4, and 24 hours of storage with the following variables to assess cellular function and viability: adenosine triphosphate, percent hemolysis, hematocrit, pH, lactate dehydrogenase, extracellular potassium, sodium, and RBC indices.
Results:
There was no difference found between irradiated and nonirradiated aliquots or aliquots stored in the refrigerator versus those stored at RT. Significant differences between aliquots stored in approved transfer bags and those stored in syringes were not identified.
Conclusions:
Irradiation and storage of aliquoted RBCs demonstrated expected but not significant changes in the in vitro variables. Storage for up to 24 hours in syringes does not have a greater detrimental effect on RBCs than storage in transfer bags, making products stored in either container safe for transfusion to pediatric patients.
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