Frozen red cells

The popularity and the promise of frozen red cells during the 1970s were largely attributable to logistic problems associated with 21-day storage and to the fringe benefits of white cell and plasma depletion that minimized alloimmunization and febrile transfusions and, it was speculated, reduced the risk of HBV transmission. Filtration, particularly with the new generation of filters now appearing on the market, promises to achieve an equivalent reduction in white cells at a fraction of the cost and inconvenience. Donor testing for HBV and anti-HIV and, as would appear from recent data, the ALT assay as a surrogate test for non-A, non-B hepatitis, have reduced the incidence of transmission of these diseases below the level where either evaluating or utilizing red cell freezing would be practically or economically feasible. The use of frozen red cells following rejuvenation will certainly be replaced by effective resuspension solutions that will permit rejuvenation, washing, and additional weeks of refrigerated storage. Barring some wholly unexpected and improbable development bringing the cost and convenience of frozen red cells close to those of refrigerated cells, there is little reason to believe that frozen red cells will find applications in the civilian market, except for the storage of rare types and, possibly, the prevention of CMV transmission in the foreseeable future. The original goal of red cell freezing, to make long term storage possible, has been fully realized. The rest is history.