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Effects of irradiation on red cells stored in CPDA-1 and CPD-ADSOL (AS-1)
E K Jeter1, R H Gadsden, J Cate
1Medical University of South Carolina, Department of Pathology/Laboratory Medicine, Charleston 29425.
Insights
Irradiation of red blood cells (pRBC) increases potassium levels, with higher levels observed in CPDA-1 compared to AS-1 anticoagulant. These findings are crucial for understanding pRBC storage and transfusion safety.
Area of Science:
- Blood banking
- Transfusion medicine
- Biochemistry
Background:
- Red blood cells (pRBC) are stored using various anticoagulants like CPDA-1 and CPD-ADSOL (AS-1).
- Irradiation of pRBC for transfusion is common, but its biochemical effects, especially concerning anticoagulant differences, require further investigation.
- Anecdotal reports suggest increased potassium (K+) post-irradiation and storage.
Purpose of the Study:
- To investigate the in vitro biochemical changes in pRBC stored with CPDA-1 and AS-1 anticoagulants after irradiation.
- To compare potassium levels, glucose utilization, plasma free hemoglobin, 2,3-DPG, and LDH between irradiated and non-irradiated pRBC units with different anticoagulants.
Main Methods:
- Blood from five volunteers was collected in CPDA-1 and AS-1 anticoagulant bags.
- Units were divided, with one half irradiated (2000 rads) and the other serving as control.
- Samples were analyzed for biochemical parameters on multiple days up to expiration.
Main Results:
- Irradiation significantly increased K+ levels by 2.3-fold within seven days for both anticoagulants.
- CPDA-1 anticoagulant showed significantly higher K+ levels compared to AS-1 after irradiation.
- Differences in glucose utilization, plasma free hemoglobin, 2,3-DPG, and LDH were observed and documented.
Conclusions:
- Irradiation impacts pRBC biochemical properties, notably increasing potassium levels.
- The choice of anticoagulant (CPDA-1 vs. AS-1) influences the extent of potassium increase post-irradiation.
- Findings highlight the importance of considering anticoagulant type in irradiated pRBC storage and transfusion protocols.
Abstract:
Red blood cells (pRBC) collected in citrate, phosphate, dextrose, adenine-formula 1 (CPDA-1) and citrate, phosphate, dextrose-adenine, manitol saline solution (CPD-ADSOL [AS-1]) anticoagulants are increasingly being stored for variable periods in transfusion service inventories following irradiation. While anecdotal reports of increased K+ following irradiation and storage have recently appeared in the literature, concomitant in vitro biochemical changes resulting from differences in anticoagulants have not been reported. Utilizing two venipunctures, two units each of 225 mL of blood from five volunteers were collected in anticoagulant-adjusted CPDA-1 and AS-1 bags. Within two hours of collection, each unit was equally divided. One of each pair was irradiated (2000 rads). Samples were analyzed on Days 0, 1, 3, 7, and every seven days to expiration. Irradiation resulted in a 2.3 fold increase in K+ during the first seven days of storage for both anticoagulants, although significantly greater K+ levels were observed in the CPDA-1 pairs compared to the AS-1 pairs. Comparison of glucose utilization, plasma free hemoglobin, 2,3-diphosphoglycerate (2,3-DPG) and lactate dehydrogenase between control and irradiated CPDA-1 and AS-1 pairs and between anticoagulants were documented.