Effects of 3‐5 log₁₀ pre‐storage leucocyte depletion on red cell storage and metabolism

Abstract

A new, in-line high-efficiency 3-5 log10 leucodepletion filter system (Leukotrap RC system) was used to investigate the effect of pre-storage white cell removal on the quality of AS-3 red cell concentrates stored for 42 d at 4 degrees C. Median residual white cell content was 4 x 10(5) when filtration was performed at 22 degrees C within 8 h of phlebotomy (n = 20) and 3.2 x 10(4) when filtration was performed at 4 degrees C 12-24 h after phlebotomy (n = 24). None exceeded 1 x 10(6) WBC per red cell product. Filtration was rapid (median 28 min), and red cell loss averaged (mean +/- 1 SD) 6.4 +/- 0.7%. In a paired study design, post-transfusion recoveries of 42 d stored red cells in the filtered units averaged 84 +/- 6% v 82 +/- 8% for unfiltered units (P < 0.05) and post-storage haemolysis. ATP, osmotic fragility, K+ and pH were significantly (P < 0.05) better in the filtered units. Reduced glycolytic activity was also observed in the filtered units, and there was a correlation between osmotic fragility, glucose consumption, and lactate produced in standard units that was not present in leucodepleted units. In conclusion, this study suggests that leucodepletion of AS-3 red cell concentrates prior to storage results in better maintenance of the integrity of the red cell membrane with reduced glycolytic activity. There was a modest improvement in post-infusion viability sufficient to offset the filtration-induced loss and to result in an equivalent red cell product.

Evaluation of a Red Cell Leukofilter Performance and Effect of Buffy Coat Removal on Filtration Efficiency and Post Filtration Storage

“…the unfiltered units were showing a greater degree of hemolysis, compared to filtered ones, yet the level of hemolysis in all the units was still well below the limit of 0.8 % suggested by the international guidelines [21]. The quantitative data arising from this study did not support concerns raised by receiving clinicians of increased hemolysis in the leukofiltered units, consistent with other studies in the literature [22][23][24][25]. Most studies ascribe this improvement of RBC survival of filtered units to the lack of hydrolytic enzymes derived from WBCs dying in the storage container [26,27].…”

“…Our results are in line with those of previous studies and indicate that the beneficial effects of prestorage leukofiltration on storage measures are greater for conventionally prepared PRBCs with a larger WBC load, whereas improvements in filtered RBCs are less in buffy coatdepleted units. [23,29].…”

Study of Incubation Conditions for Erythrocytes Osmotic Fragility Testing in Dromedary Camel (Camelus dromedarius)

“…Several reports on the effects of blood storage have shown significant alteration in RBC membrane integrity and flow properties and significant increase in the levels of free hemoglobin [21,22]. The presence of leukocytes in RBC suspension may also contribute significantly to the increase in hemolysis during storage [23,24]. During storage, leukocytes break down and release a number of chemicals and enzymes such as hydrogen peroxide and proteases.…”

Current issues relating to the transfusion of stored red blood cells

“…Furthermore, in a large review of licensure trials by Dumont and AuBuchon, all appeared to be equivalent, with approximately 82% 24-h in vivo recovery when stored as red blood cells in additive solution for 6 weeks [8]. When the red blood cells are leucoreduced at the time of initial processing, the red blood cell recovery is about 2% higher [14]. The survival of red blood cells that circulate for 24 h has been normal with a half-life of about 60 days in all systems where it has been measured.…”