Hemolysis of red blood cells after cell washing with different automated technologies: clinical implications in a neonatal cardiac surgery population

O'Leary, Mandy Flannery; Szklarski, Penny C.; Klein, Thomas M.; Young, Pampee P.

doi:10.1111/j.1537-2995.2010.02935.x

Cited by 43 publications

(50 citation statements)

References 30 publications

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“…Washed red blood cell concentrates are recommended for large-volume transfusions to potassium-sensitive patients, particularly neonates when fresh units are not available [304], for recipients who have a history of plasma-related transfusion reactions [305], and for the prevention of transfusion-related acute lung injury [306]. Recently, the use of washed RCCs has been proposed as a means to mitigate the accumulation of proinflammatory cells and molecules in stored RCCs to reduce the bioactivity of the product [307] and may be an effective means to address RBC degradation during storage.…”

Section: Overview: Quality Assessment Of Stored Red Cell Concentratesmentioning

confidence: 99%

“…RCCs can be washed in the blood bank using manual centrifugation and extraction methods, semiautomated cell processors, or just prior to transfusion using cell salvage devices [304, 308–310]. Manual washing and use of open cell processors hamper widespread use of washed RBCs as the resulting washed products have a limited storage duration.…”

Section: Overview: Quality Assessment Of Stored Red Cell Concentratesmentioning

confidence: 99%

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Quality Assessment of Established and Emerging Blood Components for Transfusion

Acker

Marks

Sheffield

2016

Journal of Blood Transfusion

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Blood is donated either as whole blood, with subsequent component processing, or through the use of apheresis devices that extract one or more components and return the rest of the donation to the donor. Blood component therapy supplanted whole blood transfusion in industrialized countries in the middle of the twentieth century and remains the standard of care for the majority of patients receiving a transfusion. Traditionally, blood has been processed into three main blood products: red blood cell concentrates; platelet concentrates; and transfusable plasma. Ensuring that these products are of high quality and that they deliver their intended benefits to patients throughout their shelf-life is a complex task. Further complexity has been added with the development of products stored under nonstandard conditions or subjected to additional manufacturing steps (e.g., cryopreserved platelets, irradiated red cells, and lyophilized plasma). Here we review established and emerging methodologies for assessing blood product quality and address controversies and uncertainties in this thriving and active field of investigation.

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Section: Overview: Quality Assessment Of Stored Red Cell Concentratesmentioning

confidence: 99%

Section: Overview: Quality Assessment Of Stored Red Cell Concentratesmentioning

confidence: 99%

Quality Assessment of Established and Emerging Blood Components for Transfusion

Acker

Marks

Sheffield

2016

Journal of Blood Transfusion

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“…The difference in in vivo recovery is not known; however, these modified products have been available for use since 2013. Overall, deglycerolization with the COBE 2991 impacts RBC hemolysis, as seen in previous studies [25,26]. It is also worth noting that this technology produces products in an open system, and the resulting products are limited by a 24-hour outdate.…”

Section: Discussionmentioning

confidence: 77%

From Development to Implementation: Adjusting the Hematocrit of Deglycerolized Red Cell Concentrates to Meet Regulatory Standards

Turner

Hansen

Kurach

et al. 2016

Transfus Med Hemother

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Background: Before transfusion, thawed frozen red cell concentrates (RCCs) must be deglycerolized. In order to ensure that these products meet regulatory standards for hematocrit, an approach to manipulate hematocrit post deglycerolization was developed and implemented. Methods: Glycerolized and frozen RCCs were thawed and deglycerolized using the COBE 2991 cell processor, and the final product's hematocrit was adjusted by addition of various volumes of 0.9% saline / 0.2% dextrose. The in vitro quality of RCCs (hematocrit, hemolysis, hemoglobin content, volume, recovery, ATP, supernatant potassium, and others) were compared to Canadian Standards Association (CSA) and other standards for deglycerolized RCCs. Results: Addition of saline/dextrose re-suspension solution in a range of 65-90 g post deglycerolization led to acceptable hematocrits. In the pilot study, this approach resulted in RCCs meeting all CSA standards for deglycerolized RCCs, with stimulation of RBC metabolism demonstrated by increased ATP concentration. In the validation phase, results were similar, although the CSA hemolysis standard was not met. Pre- and post-implementation data confirmed that manipulated RCCs met CSA hematocrit standards. Conclusion: This process was implemented at Canadian Blood Services to provide deglycerolized RCCs that meet the CSA hematocrit standard. However, pre- and post-implementation data reveal that this deglycerolization process is not sufficient to have RCCs consistently meet hemolysis standards.

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“…However, this has been shown to induce some haemolysis, both at the time of processing and (when stored in vitro) for some hours afterwards [13]. A study using RBCs up to 49 days old also found that processing with a cell-saver reduced the toxicity of the suspension fluid, and that some haemolysis occurred, but the number of bags of RBCs was smaller than in the present study, and the authors did not measure the fraction of RBCs that survived [14].…”

Section: Discussionmentioning

confidence: 99%

Conditioning out‐of‐date bank‐stored red blood cells using a cell‐saver auto‐transfusion device: effects on numbers of red cells and quality of suspension fluid

et al. 2014

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SummaryWe investigated the utility of a cell-saver device for processing out-of-date red blood cells, by washing twenty bags of red blood cells that had been stored for between 36 and 55 days. The volume of recovered cells, and the characteristics of the suspension fluid, were measured before and after treatment. The ratio of free haemoglobin to total haemoglobin was up to 0.02 before processing, and up to 0.011 afterwards, changing by between À0.013 and +0.003. This ratio met the current standard for free haemoglobin (less than 0.008 in more than 75% of samples

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Hemolysis of red blood cells after cell washing with different automated technologies: clinical implications in a neonatal cardiac surgery population

Abstract: Hemolysis levels vary among different cell washers. Decreasing the expiration time of units after washing may be warranted.

Cited by 43 publications

References 30 publications

Quality Assessment of Established and Emerging Blood Components for Transfusion

Quality Assessment of Established and Emerging Blood Components for Transfusion

From Development to Implementation: Adjusting the Hematocrit of Deglycerolized Red Cell Concentrates to Meet Regulatory Standards

Conditioning out‐of‐date bank‐stored red blood cells using a cell‐saver auto‐transfusion device: effects on numbers of red cells and quality of suspension fluid

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