Removal of ABO-incompatible red cells from lymphocytapheresis and granulocytapheresis components before transfusion

The collection of allogeneic lymphocytapheresis and granulocytapheresis components containing significant volumes of ABO-incompatible red cells is sometimes necessary.

Twenty-nine ABO-incompatible lymphocytapheresis components collected for transfusion to three patients and 11 ABO-incompatible granulocytapheresis components collected for transfusion to five patients were depleted of red cells by gravity sedimentation aided by the addition of hetastarch solution. The efficacy of red cell depletion and white cell retention and the complications of transfusion were analyzed.

Lymphocytapheresis components contained 82 +/- 13 percent of the original white cells and 5 +/- 3 mL of red cells after depletion; however, for those components containing < 70 mL of red cells before depletion (n = 12), white cell recovery was 92 +/- 5 percent. After depletion, granulocytapheresis components contained 96 +/- 3 percent of the original white cells and 6 +/- 2 mL of red cells. No clinical or laboratory evidence of hemolysis was observed after the transfusion of any leukapheresis component.

Red cells can be effectively removed from leukacytapheresis components by a simple gravity sedimentation technique with added hetastarch. This allows safe transfusion of ABO-incompatible components.