Shall red cell units stand upright, lie flat or be mixed during storage? In vitro studies of red cells collected in 0.5 CPD and stored in RAS2 (Erythrosol)

The effect of position and frequency of mixing on canine packed red blood cell units during storage

OBJECTIVE

Hemolysis is an indicator of storage lesion that occurs in stored packed red blood cells (pRBCs) over time. Intermittent mixing of red blood cells in the additive solutions may be beneficial but may also result in iatrogenic injury. Position of units in storage may also affect the quality of the pRBCs. This prospective study was designed to evaluate hemolytic effect of mixing frequency and storage position on canine pRBCs over a period of 28 days.

DESIGN

Prospective in vitro study SETTING: Private practice referral hospital with an internal blood bank ANIMALS: Thirty-two healthy prescreened dogs enrolled in a volunteer blood banking program INTERVENTIONS: None MEASUREMENTS AND MAIN RESULTS: A total of 160 samples were evaluated. Forty canine pRBC units were split into 4 daughter bags and stored in varying positions with different mixing frequencies. Samples were stored upright and mixed daily, upright and mixed weekly, horizontally and mixed daily, or horizontally and mixed weekly for a period of 28 days. At days 0, 7, 14, and 28, samples from the units were analyzed to calculate percent hemolysis. No differences were found in any hemolytic indicators investigated (total hemoglobin, free plasma hemoglobin, and packed cell volume) until day 28 in all test groups. Canine pRBCs stored upright and mixed weekly or stored horizontally and mixed weekly resulted in less hemolysis and free plasma hemoglobin when compared to units stored horizontally and mixed daily only at day 28.

CONCLUSIONS

Statistically significant hemolysis was not evident amongst canine pRBC groups less than 28 days old suggesting that positioning and mixing frequency was irrelevant until day 28. Beyond 28 days despite the presence of hemolysis, no definitive recommendation could be made with respect to best practice for storage position or mixing frequency of stored canine pRBCs.

Effects of four additive solutions on canine leukoreduced red cell concentrate quality during storage

BACKGROUND

Additive solutions (AS) and prestorage leukoreduction (LR) are important tools used to maintain erythrocyte viability during storage and avoid transfusion reactions in recipients, respectively.

OBJECTIVES

The purpose of the study was to determine the efficacy of a WBC filter (Immugard IIIRC) and compare the effect of 4 AS (phosphate-adenine-glucose-guanosine-gluconate-mannitol [PAGGGM], saline-adenine-glucose-mannitol [SAGM], Adsol, Optisol) on the in vitro quality of canine leukoreduced packed RBC units (pRBC) stored for 41 days.

METHODS

Five hundred milliliters of blood were collected from 8 healthy dogs each into 70 mL of citrate-phosphate-dextrose (CPD) solution, and were leukoreduced by a polyurethane filter. pRBC of each dog were divided equally into 4 bags containing a different AS. Bags were stored for 41 days at 4°C and evaluated every 10 days. Variables analyzed included pH, PCV, and% hemolysis, and lactate, glucose, potassium, sodium, ATP, and 2,3-diphosphoglycerate (2,3-DPG) concentrations.

RESULTS

The LR resulted in residual WBC counts comparable to human standards. During storage, pH, and glucose, 2,3-DPG, and ATP concentrations decreased, and hemolysis, and lactate, sodium, and potassium concentrations increased (P < .05). Significant differences between AS were seen in the glucose and sodium concentrations, due to the composition of AS. Also, the pH maintained by PAGGGM at day 21 was significantly higher than that seen with SAGM or Adsol.

CONCLUSIONS

All AS used gave satisfactory results during the first 21 days of storage based on the degree of hemolysis, and on ATP and 2,3-DPG concentrations. When compared with day 1 values, significant changes were seen in these variables by day 31 with all AS.

In vivo recovery and survival of red cells after photodynamic treatment with thiopyrylium and red light using a canine model

Recently, we have shown that thiopyrylium has robust inactivation capabilities against a broad spectrum of pathogens in the human red blood cell (RBC) suspensions while retaining key RBC in vitro properties. The 24-h recovery and survival of canine red cells were measured upon autologus reinfusion of control and phototreated units. The 24-h recovery of control and phototreated RBCs was 75.7 +/- 6.4% and 87.5 +/- 8.5%, respectively. The time for 50% survival of labelled control RBCs was similar to that of phototreated group (206 +/- 58 h vs. 255 +/- 63 h, respectively). Results suggest that thiopyrylium phototreatment does not negatively affect canine RBC in vivo recovery.

Prestorage leukocyte reduction with in-line filtration of whole blood: evaluation of red cells and plasma storage

OBJECTIVES

Prestorage filtration of blood components appears to be an effective method to reduce leukocyte-induced adverse reactions and other complications. To determine whether it is better to filter whole blood before component separation, we compared the efficiency of in-line filtration of whole blood with that of postseparation filtration.

METHODS

Blood was collected from normal, healthy donors into either regular triple-bag containers or into whole-blood integral-filter container systems. We then compared the in vitro storage values of leukocyte-depleted red blood cell concentrates (RBCC) kept at 4 degrees C, and plasma frozen for 1 year with nonfiltered blood components as control.

RESULTS

All counts of white blood cells after filtration were < 1 x 10(6) per unit. For almost all storage parameters no significant differences were found between leukocyte-reduced RBCC and control units. The plasma fibrinopeptide A values below 30 ng/ml prior to freezing indicate that filtration does not activate the coagulation factors. Furthermore, the filtration did not influence either the biological values or the coagulation factors of plasma units.

CONCLUSIONS

Whole blood filtration prior to component preparation seems to offer a useful alternative technique for obtaining leukocyte-reduced RBCC and plasma.