Lipaemic donations: truth and consequences

The problem of using material of unsuitable quality, including "nontransparent turbid milky plasma" or more simply "turbid plasma", for producing blood components is not trivial for several epidemiological, technical, analytical, clinical and economical reasons. With some exception, most national and international guidelines mandate that blood components should preferably not be produced from lipaemic donations. The origin of lipaemic blood is variegated, and includes physiological or paraphysiological causes and metabolic disorders, whereas a broad range of common diseases and drugs can also be associated with hypertriglyceridaemia. Overall, the frequency of lipaemic donations ranges between 0.31% and 0.35%, although sporadic reports have highlighted that the frequency might be much higher, up to 13%. Lipaemic donations pose two leading problems in transfusion medicine, that are interference during laboratory testing, and safety of producing blood components from hypertriglyceridaemic materials. While the former issue can be overcome by using chemical or mechanical methods, the clinical use of lipaemic blood for producing components remains an unresolved question. Transfusion medicine should thereby embark on a landmark effort to find a universal agreement of behaviours and harmonization of policies worldwide.