Transfusion of irradiated red blood cell units with a potassium adsorption filter: A randomized controlled trial

Cid, Joan; Villegas, Vanessa; Carbassé, Gloria; Alba, Cristina; Perea, Dolores; Lozano, Miguel

doi:10.1111/trf.13536

Cited by 11 publications

(10 citation statements)

References 21 publications

(27 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, the use of potassium absorption filters during transfusion may also decrease potassium loading[12,13]. Moreover, factors that also play a role in the increase of potassium levels are the rate and volume of transfusion as well as the patient’s circulating pre-transfusion blood volume.…”

Section: Discussionmentioning

confidence: 99%

Severe hyperkalemia following blood transfusions: Is there a link?

Rizos

Milionis

Elisaf

2017

WJN

View full text Add to dashboard Cite

Patients with gastrointestinal bleeding often require large volume blood transfusion. Among the various side effects of blood transfusion, the increase of potassium levels is a serious one which is often overlooked. We report a case of severe hyperkalemia in a patient with gastric bleeding after large volume transfusion of packed red blood cells. The patient had hyperkalemia at baseline associated with his receiving medication as well as acute renal failure following hypovolemia. The baseline hyperkalemia was further aggravated after massive transfusions of packed red blood cells in a short period of time. The associated pathogenetic mechanisms resulting in the increase of potassium levels are presented. A number of risk factors which increase the risk of hyperkalemia after blood transfusion are discussed. Moreover, appropriate management strategies for the prevention of blood transfusion associated hyperkalemia are also presented. Physicians should always keep in mind the possibility of hyperkalemia in cases of blood transfusion.

show abstract

Section: Discussionmentioning

confidence: 99%

Severe hyperkalemia following blood transfusions: Is there a link?

Rizos

Milionis

Elisaf

2017

WJN

View full text Add to dashboard Cite

show abstract

“…These filters have also been shown to remove excess ammonium from RBC units (76%–87% reduction), fresh frozen plasma (21%–31% reduction), platelets (53% reduction), and albumin solutions (49%–92% reduction) reducing the risk of ammonium acting as a neurotoxin during traumatic brain injury or in neonates with underdeveloped blood–brain barriers 61. However, PAF filters are not currently compatible with rapid blood transfusion devices, and more research is still needed to determine the effect of PAF filtration on RBC quality 62,63. Although evidence is limited on the clinical feasibility and advantages of incorporating PAF filtration to standard blood transfusions, the apparent permissible flow rates could allow for high-throughput blood banking applications beyond the specific clinical significance of this technology for neonatal and pediatric hematology practices.…”

Section: Centrifugation-free Technologiesmentioning

confidence: 99%

Traditional and emerging technologies for washing and volume reducing blood products

Lu¹,

Lezzar²,

Vörös³

et al. 2019

JBM

View full text Add to dashboard Cite

Millions of blood components including red blood cells, platelets, and granulocytes are transfused each year in the United States. The transfusion of these blood products may be associated with adverse clinical outcomes in some patients due to residual proteins and other contaminants that accumulate in blood units during processing and storage. Blood products are, therefore, often washed in normal saline or other media to remove the contaminants and improve the quality of blood cells before transfusion. While there are numerous methods for washing and volume reducing blood components, a vast majority utilize centrifugation-based processing, such as manual centrifugation, open and closed cell processing systems, and cell salvage/autotransfusion devices. Although these technologies are widely employed with a relatively low risk to the average patient, there is evidence that centrifugation-based processing may be inadequate when transfusing to immunocompromised patients, neonatal and infant patients, or patients susceptible to transfusion-related allergic reactions. Cell separation and volume reduction techniques that employ centrifugation have been shown to damage blood cells, contributing to these adverse outcomes. The limitations and disadvantages of centrifugation-based processing have spurred the development of novel centrifugation-free methods for washing and volume reducing blood components, thereby causing significantly less damage to the cells. Some of these emerging technologies are already transforming niche applications, poised to enter mainstream blood cell processing in the not too distant future.

show abstract

“…Various PAF designs, using cation exchange resin (polystyrene sulfonic acid) to adsorb potassium ions (K + ), are intended to lessen hyperkalemia in stored and irradiated RBC components. [9][10][11] A large-capacity PAF, the KPF-4 (Kawasumi Laboratories Inc., Tokyo, Japan, for up to 560 mL of RBC) is used at a flow rate of 50 mL/h or less. The smallercapacity KPF-1 (Kawasumi, for a standard Japanese RBC Clinical Trial Registration: No clinical trial registration.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessment of a downsized potassium adsorption filter designed to transfuse neonates

et al. 2020

View full text Add to dashboard Cite

Background: During storage, the potassium level of red blood cell (RBC) components increases, especially after irradiation. Neonates are prone to hyperkalemia, for example, non-oliguric hyperkalemia, so using potassium adsorption filters during transfusion may be helpful. To overcome dilution of RBC components caused by saline priming of existing potassium adsorption filters, a downsized potassium adsorption filter for neonates (PAF-n, Kawasumi Laboratories Inc., Tokyo, Japan) was developed. Study Design and Methods: To assess the performance of PAF-n, its adsorption efficiency and RBC recovery rate were evaluated by testing pre-filtration and serial post-filtration (0-30 mL, 30-60 mL, 60-90 mL, and 90-120 mL) samples from 8 RBC components. Results: The average potassium adsorption rate of the PAF-n was 90.5% ± 0.78%, and never less than 89.0% in any of 8 RBC components. RBC recovery rates were 99.3% ± 1.12%. Conclusion: The PAF-n showed an effective potassium ability with negligible RBC dilution.

show abstract

Transfusion of irradiated red blood cell units with a potassium adsorption filter: A randomized controlled trial

Abstract: The transfusion of 1 irradiated RBC unit with the PAF was as safe and efficacious as the transfusion of 1 irradiated RBC unit with the standard blood infusion set in patients with chemotherapy-induced anemia.

Cited by 11 publications

References 21 publications

Severe hyperkalemia following blood transfusions: Is there a link?

Severe hyperkalemia following blood transfusions: Is there a link?

Traditional and emerging technologies for washing and volume reducing blood products

Assessment of a downsized potassium adsorption filter designed to transfuse neonates

Contact Info

Product

Resources

About