Cold‐stored leukoreduced whole blood: Extending the time between donation and filtration has minimal impact on in vitro quality

Abstract

Background Leukoreduced whole blood (LR‐WB) has received renewed attention as alternative to component‐based transfusion in trauma. According to the manufacturer's instructions, leukoreduction should be carried out within 8 h after collection. This study assessed impact of (1) WB collection bag, (2) LR filtration, and (3) timing of filtration on in vitro quality. Study Design and Methods WB collected into different vendor bags was held at room temperature for <8 h or >16 h but <24 h prior to LR. In vitro quality was assessed before and after filtration, and throughout 3 weeks of storage at 4°C. Cell count and hemoglobin levels were determined by hematology analyzer, platelet activation, and responsiveness to ADP by surface expression of P‐selectin by flow cytometry, hemolysis by HemoCue, and metabolic parameters by blood gas analyzer. Hemostatic properties were assessed by rotational thromboelastometry. Plasma protein activities and clotting times were determined by automated coagulation analyzer or quantitative immunoblotting. Results Bag type had no impact on WB in vitro quality. LR by filtration had some impact, but is aligned with data in the literature. The time between donation and filtration resulted in some statistically significant differences in metabolic activity, platelet yield, platelet activation, and factor protein activity initially; however, these differences in in vitro quality attributes decreased throughout 21‐day cold storage. Conclusion WB hold time showed only a minor impact on WB in vitro quality, so it may be possible for blood processing facilities to explore extended hold times prior to filtration in order to provide greater operational flexibility.

Sangre total leucorreducida y filtro ahorrador de plaquetas preserva su función hemostática por 21 días: ¿La resucitación hemostática podría ser una realidad en Colombia?

“…El método de leucorreducción y filtración de ahorro de plaquetas en los últimos años parecer ser el mejor para la preservación de sangre total, con facilidades en su conservación y sin compromiso a corto plazo si hay tardanza entre la donación y el filtración de las unidades 21,22 .…”

Assessment of bacterial growth in leukoreduced cold‐stored whole blood supports overnight hold at room temperature prior to filtration: A pilot study

“…The potential impact of SS or TSB on in vitro LCWB quality was determined using published protocols [11]. Briefly, each three LCWB units containing 5 ml of the unspiked diluents SS or TSB were warmed at RT for 30 min, manually mixed and sampled.…”

“…While only 5 ml of SS or TSB (representing $1% of the WB volume) was used, the potential impact of these diluents on in vitro LCWB quality was determined. Quality parameters collected throughout 21-day storage were compared to previous data [11]. No impact on in vitro quality by either diluent was observed (Table 1).…”

“…In vitro WB quality parameters (units) Note: In vitro quality parameters (average AE SD; n = 3 for each diluent) determined of WB containing only the diluent of the bacteria, either SS or TSB upon leukoreduction filtration on day 0 and throughout cold storage for 21 days. As control data, corresponding data obtained from a previous study with WB that did not include diluents [11] is displayed in the right column shaded in light grey. Abbreviation: N/d, not determined; PLT, platelet; SS, saline solution; TSB, trypticase soy broth; WB, whole blood; WBC, white blood cell.…”

“…As per manufacturer's instructions, leukoreduction should be performed within 8 h of blood collection. However, we have recently demonstrated that extending the time to WB filtration from 8 to 24 h, had no significant effect on LCWB in vitro quality and functionality during 21 days of refrigerated storage [11]. A similar approach of extending the time prior to leukoreduction has been adopted in this study to evaluate the impact of WB hold at room temperature (RT) on bacterial survival.…”