Possible red blood cell damage due to iatrogenic transfusion filter-related mistakes during blood transfusion

Abstract

Background: Red cell concentrates are usually transfused through a transfusion filter. Iatrogenic accidents can occur in which the red blood cell concentrate is transfused through the infusion filter by mistake. Therefore, we examined the extent of red blood cell damage in red cell concentrates transfused through transfusion and infusion filters ex vivo. Methods: We evaluated red blood cell damage using lactate dehydrogenase, free hemoglobin, and erythrocyte membrane phosphatidylserine expression in red cell concentrates transfused through transfusion and infusion filters (transfusion rate: 100mL/h). In addition, we performed hemolytic experiments using a 50% glucose solution in red cell concentrates transfused through both filters. Results: Red cell concentrates transfused through infusion filters revealed higher lactate dehydrogenase, free hemoglobin, and phosphatidylserine expression levels than those transfused through transfusion filters. The 50% glucose solution induced hemolysis of the red cell concentrates from the infusion filters more strongly than those from the transfusion filters. Conclusion: An iatrogenic mistake from the transfusion filter to the infusion filter might induce red blood cell damage.

Quality Control of Red Blood Cell Solutions for Transfusion Transported via Drone Flight to a Remote Island

“…A transfusion set-pass experiment, unique to us, was used to assess RBC solution quality. We previously reported that RBC solution had hemolytic activity after filtration, which was mainly due to poor temperature control during vehicle transport that may increase the LDH levels in RBC solutions after transport, even if LDH is not a problem due to transfusion set-pass [25]. This emphasizes the importance of measuring LDH, which passes through the transfusion filter before transfusion in clinical settings.…”

Appropriate transport of whole blood by drones for cases of massive bleeding

“…Part of the WBs in the packs were passed through a filter, transfusion set (Terumo Co. Ltd., Tokyo, Japan). 10 The WB samples in the no-travel, flight, and non-flight groups, which were centrifuged at 3500 rpm for 10 min, underwent measurements of lactate dehydrogenase (LDH) and other biochemical indices and also subjected to coagulation tests.…”