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Primary prevention of pediatric lead exposure requires new approaches to transfusion screening

Eric Gehrie1, Amaris Keiser, Sheila Dawling

  • 1Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.

The Journal of Pediatrics
|April 16, 2013
PubMed

Insights

Transfusion of packed red blood cells (pRBCs) can expose patients to lead. This study developed a method to measure lead in pRBCs, finding detectable levels in all units tested, highlighting a potential source of pediatric lead exposure.

Area of Science:

  • Environmental Health
  • Hematology
  • Toxicology

Background:

  • Transfusion-associated lead exposure is a concern.
  • Assessing lead levels in transfused blood products is crucial for patient safety.

Purpose of the Study:

  • To develop and validate a procedure for quantifying lead concentration in packed red blood cells (pRBCs).
  • To investigate the relationship between whole blood lead and pRBC lead concentrations.

Main Methods:

  • A modified clinical assay was used to analyze 27 blood samples.
  • Lead concentrations were measured in 100 pRBC units.

Main Results:

  • A strong correlation (R² = 0.82) was found between whole blood and pRBC lead levels.
  • All 100 tested pRBC units contained detectable lead, with a median concentration of 0.8 μg/dL.
  • Significant lead was found in supernatant plasma after short storage periods.

Conclusions:

  • Packed red blood cell transfusions represent a significant source of lead exposure.
  • The developed method allows for the quantification of lead in pRBCs.
  • Pretransfusion testing or donor screening could mitigate pediatric lead exposure from transfusions.
Abstract

Keywords:
CDCCenters for Disease Control and PreventionICP-MSInductively coupled plasma mass spectrometryPacked red blood cellVUMCVanderbilt University Medical CenterWHOWorld Health OrganizationpRBC

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