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Updated: Jan 4, 2026

A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy
Effects of Blood Transfusion Sets on Red Blood Cell Hemolysis
Larissa Perez Pardo1, Denise Miyuki Kusahara, Maria Paula de Oliveira Pires
1Universidade Federal de São Paulo, São Paulo, Brazil (Mss Pardo and Drs Pires, Avelar, Kusahara, Peterlini, and Pedreira); Paulista University, São Paulo, Brazil (Ms Pardo and Pires); The Alliance for Vascular Access Teaching and Research (AVATAR) Group, Menzies Health Institute Queensland at Griffith University, Brisbane, Queensland, Australia (Ms Pires); Colsan Blood Collection Association, São Paulo, Brazil (Mr Nani). Larissa Perez Pardo, MSN, RN, is an adjunct professor of nursing at Paulista University and a PhD candidate in the Paulista School of Nursing at the Universidade Federal de São Paulo. Denise Miyuki Kusahara, PhD, RN, is an adjunct professor at Universidade Federal de São Paulo-Brazil. Maria Paula de Oliveira Pires, PhD, RN, is an adjunct professor in nursing at Paulista University. She is also an adjunct research fellow at Universidade Federal de São Paulo and the AVATAR group Menzies Health Institute Queensland at Griffith University in Brisbane, Australia. Luiz Augusto Silva Nani, BS, is a biologist specialist in clinical and toxicological analyses, and laboratory supervisor of the blood components quality control at Colsan Blood Collection Association in São Paulo, Brazil. Ariane Ferreira Machado Avelar, PhD, RN, is an associate professor at the Universidade Federal de São Paulo-Brazil. Maria Angélica Sorgini Peterlini, PhD, RN, is associate professor at the Federal University of São Paulo. Mavilde Luz Gonçalves Pedreira, PhD, RN, is associate professor at the Federal University of São Paulo.
Abstract:
This experimental randomized study compared the effects of macrodrop and microdrop blood transfusion sets on red blood cell (RBC) hemolysis. Twenty units of packed RBCs from different donors were infused through 48 infusion sets from 2 manufacturers at infusion rates of 10 and 100 mL/h. Pre- and postinfusion analysis was performed to determine total hemoglobin (g/dL), hematocrit (%), free hemoglobin (g/dL), potassium (mmol/L), haptoglobin (g/L), and degree of hemolysis (%). The results demonstrated that the level of free hemoglobin (P < .001) and degree of hemolysis (P < .001) increased postinfusion. A higher degree of hemolysis was noted when the RBCs were infused at a rate of 10 mL/h through a microdrop blood transfusion set.
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