Evaluating the quality of red blood cell concentrates irradiated before or after cryopreservation.


Journal

Transfusion
ISSN: 1537-2995
Titre abrégé: Transfusion
Pays: United States
ID NLM: 0417360

Informations de publication

Date de publication:
01 2020
Historique:
received: 27 08 2019
revised: 19 10 2019
accepted: 24 10 2019
pubmed: 15 11 2019
medline: 2 9 2020
entrez: 15 11 2019
Statut: ppublish

Résumé

Cryopreserved red blood cell concentrates (RCCs) are often required for patients with rare blood groups. Although transfusions from blood relatives are irradiated before transfusion, research has yet to make clear if this is necessary in cryopreserved RCCs. Given insufficient evidence to the contrary, irradiation of cryopreserved RCCs has been recommended, but the effect of irradiation timing is unknown. Therefore, this study was performed to assess the effect of RCC irradiation pre- and postcryopreservation on RCC quality. Nine whole blood units from healthy donors were processed into RCCs using the buffy coat method. ABO- and Rh-matched units were pooled and split into three groups: precryopreservation irradiation (pre-CIG), postcryopreservation irradiation (post-CIG), and nonirradiated controls. Hemoglobin, hematocrit, white blood cell (WBC) count, extracellular potassium, mean cell volume, red blood cell (RBC) morphology, and RBC deformability were measured. Extracellular potassium was greater in the irradiated conditions when compared to the nonirradiated controls and was greater in the post-CIG group when compared to the pre-CIG group (p < 0.05). WBC counts decreased after cryopreservation in all groups to values lower than the sensitivity of the assay. RBC deformability was greater in the post-CIG group when compared to the pre-CIG group and control group. No other significant differences were observed between groups. Irradiation of RCCs can be performed pre- or postcryopreservation with little effect on the RCC product, as both irradiated groups resulted in RCCs that were comparable to the nonirradiated cryopreserved RCCs.

Sections du résumé

BACKGROUND
Cryopreserved red blood cell concentrates (RCCs) are often required for patients with rare blood groups. Although transfusions from blood relatives are irradiated before transfusion, research has yet to make clear if this is necessary in cryopreserved RCCs. Given insufficient evidence to the contrary, irradiation of cryopreserved RCCs has been recommended, but the effect of irradiation timing is unknown. Therefore, this study was performed to assess the effect of RCC irradiation pre- and postcryopreservation on RCC quality.
STUDY DESIGN AND METHODS
Nine whole blood units from healthy donors were processed into RCCs using the buffy coat method. ABO- and Rh-matched units were pooled and split into three groups: precryopreservation irradiation (pre-CIG), postcryopreservation irradiation (post-CIG), and nonirradiated controls. Hemoglobin, hematocrit, white blood cell (WBC) count, extracellular potassium, mean cell volume, red blood cell (RBC) morphology, and RBC deformability were measured.
RESULTS
Extracellular potassium was greater in the irradiated conditions when compared to the nonirradiated controls and was greater in the post-CIG group when compared to the pre-CIG group (p < 0.05). WBC counts decreased after cryopreservation in all groups to values lower than the sensitivity of the assay. RBC deformability was greater in the post-CIG group when compared to the pre-CIG group and control group. No other significant differences were observed between groups.
CONCLUSION
Irradiation of RCCs can be performed pre- or postcryopreservation with little effect on the RCC product, as both irradiated groups resulted in RCCs that were comparable to the nonirradiated cryopreserved RCCs.

Identifiants

pubmed: 31724744
doi: 10.1111/trf.15589
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

26-29

Subventions

Organisme : Canadian Blood Services
Pays : International

Informations de copyright

© 2019 AABB.

Références

AABB. Standards for blood banks and transfusion services. AABB: Bethesda (MD); 2018. p. 122.
European Directorate for the Quality of Medicines & HealthCare. Guide to the preparation, use and quality assurance of blood components. 19th ed. Strasbourg, France: Council of Europe; 2017.
BCSH Blood Transfusion Task Force. Guidelines on gamma irradiation of blood components for the prevention of transfusion-associated graft-versus-host disease. Transfus Med 1996;6:261-71.
Treleaven J, Gennery J, Marsh J, et al. Guidelines on the use of irradiated blood components prepared by the British Committee for Standards in Haematology blood transfusion task force. Br J Haematol 2011;152:35-51.
Standards Council of Canada. Blood and blood components (CAN/CSA-Z902-15), Vol. 152. Toronto, Canada: CSA Group; 2018.
Hannon J, Hume H. CMV seronegative, irradiated and washed blood components clinical guide to transfusion. Toronto, Ontario, Canada: Canadian Blood Services; 2007. p. 146-53.
NAC-CCNMT Irradiation Working Group. Recommendations for use of irradiated blood components in Canada: a NAC and CCNMT Collaborative Initiative. Canada: National Advisory Committee on Blood and Blood Products; 2017.
Winter K, Johnson L, Webb R, et al. Gamma-irradiation of deglycerolized red cells does not significantly affect in vitro quality. Vox Sang 2015;109:231-8.
Crowley J, Valeri C. The purification of red cells for transfusion by freeze preservation and washing. Transfusion 1974;14:196-202.
Perkins H, Senecal I, Howell E. Leukocyte contamination of red cells in leukocyte-poor and frozen-deglycerolized units. Transfusion 1973;13:194-9.
Acker J, Hansen A, Kurach J, et al. A quality monitoring program for red blood cell components: in vitro quality indicators before and after implementation of semiautomated processing. Transfusion 2014;54:2534-43.
Turner T, Hansen A, Kurach J, et al. From development to implementation: adjusting the hematocrit of deglycerolized red cell concentrates to meet regulatory standards. Transfus Med Hemother 2017;44:30-8.
Almizraq R, Tchir J, Holovati J, et al. Storage of red blood cells affects membrane composition, microvesiculation, and in vitro quality. Transfusion 2013;53:2258-67.
Stadnick H, Onell R, Acker J, et al. Eadie-Hofstee analaysis of red blood cell deformability. Clin Hemorheol and Microcirc 2011;47:229-39.
Sowemimo-Coker S, Acker JP, Narla M, et al. Development of a statistical model for predicting in vivo viability of red blood cells: Importance of red cell membrane changes. Transfusion 2015;55:56A-57A.
Arnaud FG, Meryman HT. WBC reduction in cryopreserved RBC units. Transfusion 2003;43:517-25.
Palmer D, Birch P, O'Toole J, et al. Flow cytometric determination of residual white blood cell levels in preserved samples from leukoreduced blood products. Transfusion 2008;48:118-28.
Pelszynski M, Moroff G, Luban N, et al. Effect of gamma irradiation of red blood cell units on T-cell inactivation as assessed by limiting dilution analysis: implications for preventing transfusion-associated graft-versus-host disease. Blood 1994;83:1683-9.

Auteurs

Tracey R Turner (TR)

Centre for Innovation, Canadian Blood Services, Edmonton, Alberta, Canada.

Larissa Lautner (L)

Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.

Angela Hill (A)

Centre for Innovation, Canadian Blood Services, Edmonton, Alberta, Canada.

Anita Howell (A)

Centre for Innovation, Canadian Blood Services, Edmonton, Alberta, Canada.

Robert Skeate (R)

Canadian Blood Services, Toronto, Ontario, Canada.

Jason P Acker (JP)

Centre for Innovation, Canadian Blood Services, Edmonton, Alberta, Canada.
Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada.

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