Prospective, Paired Crossover Comparison of the in vitro Quality of Red Blood Cells Collected by the Automate for Blood Collection Device or by a Conventional Method

The influence of maintaining the correct whole blood-to-anticoagulant ratio during donation on the quality of leukoreduced whole blood

BACKGROUND

It is unclear whether maintaining the correct whole blood-to-anticoagulant (WB : AC) ratio during collection can improve the quality of red blood cell (RBC)-containing blood products to a clinically relevant degree.

STUDY DESIGN AND METHODS

A total of 2 × 20 CPDA-1 leukoreduced whole blood (WB) units suspended in CPDA-1 were investigated. In one group, AC was continuously added to the donated blood, maintaining the correct WB : AC ratio during collection, using a new drawing device (MacoPharma ABC). In the other group, WB units were produced conventionally. Adenosine triphosphate (ATP), 2,3-diphosphoglycerate, free hemoglobin (Hb), potassium, glucose, lactate, pH, and variables of coagulation were determined on Days 1, 7, 21, 35, 42, and 49 of storage. Variables of RBC deformability and aggregability were determined using a laser-assisted optical rotational cell analyzer.

RESULTS

The ABC and conventional group showed comparable unit volumes of 525 (SD, 5.3) mL versus 524 (SD, 10.2) mL and Hb content of 65.9 (SD, 5.1) g/unit versus 67.5 (SD, 7.8) g/unit, but higher variation after conventional blood drawing (p = 0.006 and p = 0.07, respectively) was observed. During storage, none of the measured quality variables were significantly different between the groups. Mean (SD) ATP was 2.33 (0.41) µmol/g Hb versus 2.24 (0.39) µmol/g Hb after 42-day storage. Deformability was not different (p = 0.44), whereas the extent of the aggregability was higher in the conventional group (p = 0.04).

CONCLUSION

The ABC device provided a better standardized blood product but did not improve RBC storage variables or plasma quality. It slightly reduced RBC aggregability during storage. Excess AC at the beginning of a donation appears not to significantly affect RBC storage in conventional blood drawing.