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Red cell hemolysis during processing and storage
R B Sawant1, S K Jathar, S B Rajadhyaksha
1Department of Transfusion Medicine, Advanced Centre for Treatment Research and Education in Cancer (ACTREC),Tata Memorial Centre, Sector 22, Kharghar, Navi Mumbai - 410210, India.
Red blood cell hemolysis increases during storage, particularly in the first week. Triple blood bags showed higher hemolysis, LDH, and potassium levels compared to quadruple bags, though all remained below 0.8% by day 28.
Area of Science:
- Blood banking and transfusion medicine
- Biochemistry and cellular physiology
Background:
- Plasma hemoglobin measurement offers an objective assessment of red blood cell hemolysis during storage.
- Visual inspection alone is insufficient for quantifying red cell damage.
Purpose of the Study:
- To compare hemolysis levels in red blood cells stored in triple versus quadruple blood bags.
- To evaluate the impact of storage duration on red cell hemolysis.
Main Methods:
- Fifty units of packed red cells were stored in either triple (CPD-A1 and SAGM) or quadruple (CPD-A1 and ADSOL) bags.
- Plasma hemoglobin was measured using the tetramethylbenzidiene (TMB) method on days 1, 7, 14, 21, and 28.
- Hemoglobin, hematocrit, MCV, LDH, and potassium levels were also monitored.
Main Results:
- Red blood cell hemolysis increased throughout storage, with a significant rise in the first week.
- Triple blood bags exhibited significantly higher hemolysis, LDH, and potassium levels compared to quadruple bags.
- By day 28, free hemoglobin levels in all units were below the 0.8% hemolysis threshold.
Conclusions:
- Red cell hemolysis escalates with processing and storage, peaking within the initial week.
- Implementing robust process controls and optimal storage conditions is crucial for minimizing red cell hemolysis.
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