Timing of gamma irradiation and blood donor sex influences in vitro characteristics of red blood cells

Korte, Dirk de; Thibault, Louis; Handke, Wiebke; Harm, Sarah; Morrison, Alex; Fitzpatrick, Áine; Marks, Denese C.; Yi, Qilong; Acker, Jason P.; Collaborative, Biomedical Excellence for Safer Transfusion

doi:10.1111/trf.14481

Cited by 21 publications

(32 citation statements)

References 31 publications

(45 reference statements)

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“…The magnitude of this effect of irradiation on red cells is dependent upon the age of red cells prior to irradiation, dose of irradiation and length of storage once irradiated. Irradiation of red cells in the last few weeks of their normal shelf life, currently permitted by AABB standards ( Standards for Blood Banks and Transfusion Services , 32nd Edition), 44 and Council of Europe guide ( Guide to the Preparation, Use and Quality Assurance of Blood Components , 20th Edition, 2020) 32 , results in increased haemolysis of red cells 60,61 and reduced post‐transfusion red cell recovery, although recovery is still above the minimum defined as acceptable by the United States Food and Drug Administration (75%) 62,63 . As red cells can be irradiated up to 14 days after collection and stored for a maximum of a further 14 days without significant loss of viability 64 or haemolysis, 61 and there is little operational gain in enabling irradiation later in shelf life in the UK, it is recommended that red cells are irradiated within 14 days from collection, and stored for a maximum of 14 days after irradiation.…”

Section: Manufacturing Aspects For Irradiated Componentsmentioning

confidence: 99%

Guidelines on the use of irradiated blood components

et al. 2020

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This guideline was compiled according to the British Society for Haematology (BSH) process at https://b-s-h.org.uk/med ia/16732/bsh-guidance-development-process-dec-5-18.pdf. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) nomenclature was used to evaluate levels of evidence and to assess the strength of recommendations. The GRADE criteria can be found at http:// www.gradeworkinggroup.org. Literature review details The last guideline covering this topic was published in 2012. Publications were searched systematically in English between 2008 and August 2019 covering the period since the last publication (Appendices 2 and 3). Review of the manuscript Review of the manuscript was performed by the BSH Guidelines Committee Transfusion Task Force, the BSH Guidelines Committee and the Transfusion and Malignant Haematology sounding board of BSH, and relevant specialists including paediatric cardiac anaesthetists and haematologists specialising in malignant diseases. It was also on the members section of the BSH website for comment. Purpose To provide healthcare professionals with clear guidance on situations when the use of irradiated blood components is indicated. The term 'blood component' means the therapeutic constituents of human blood (red cells, white cells, platelets and plasma) that can be prepared by various methods (JPAC https://www.transfusionguidelines.org/red-book/defini tions). The multidisciplinary writing group developed evidence-based clarification and practical guidance in clinical areas of ambiguity. Publications relating to patients of all age groups have been assessed. The guidance may not be appropriate in all patient situations and assessment of individual circumstances with the appropriate risk assessments and patient involvement may lead to alternative decisions.

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Section: Manufacturing Aspects For Irradiated Componentsmentioning

confidence: 99%

Guidelines on the use of irradiated blood components

et al. 2020

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“…Some of these changes (e.g., increased hemolysis and potassium loss) could cause harm to certain recipients [287, 288]. For these reasons, the timing of irradiation during RCC storage and the length of the postirradiation storage period are thought to be critical to the quality of gamma-irradiated RCCs [289, 290]. …”

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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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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“…While gamma irradiation of RBCs is indicated for patients with malignancy or transplants to prevent transfusion‐associated graft‐versus‐host disease, receipt of these blood components has been associated with smaller Hb increments, even when accounting for these patient comorbidities . Timing of gamma irradiation and overall storage duration have been shown to impact rates of hemolysis and other measures of RBC quality . In our study, reduced Hb increments related to gamma irradiation did not vary by storage duration except for RBC units from smokers.…”

Section: Discussionmentioning

confidence: 45%

Additive effects of blood donor smoking and gamma irradiation on outcome measures of red blood cell transfusion

et al. 2020

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BACKGROUND Recent publications have reported conflicting results regarding the role of blood donor tobacco use on hemoglobin (Hb) levels in patients after red blood cell (RBC) transfusion. We examined associations and interactions between donor, component, and recipient factors to better understand the impact of donor smoking on transfusion outcomes. STUDY DESIGN AND METHODS We linked blood donor and component manufacturing data, including self‐reported cigarette smoking, with a cohort of patients transfused RBCs between 2013 and 2016. Using multivariable regression, we examined Hb increments and subsequent transfusion requirements after single‐unit RBC transfusion episodes, adjusting for donor, component, and recipient factors. RESULTS We linked data on 4038 transfusion recipients who received one or more single‐unit RBC transfusions (n = 5086 units) to donor demographic and component manufacturing characteristics. Among RBC units from smokers (n = 326), Hb increments were reduced after transfusion of gamma‐irradiated units (0.76 g/dL; p = 0.033) but not unirradiated units (1.04 g/dL; p = 0.54) compared to those from nonsmokers (1.01 g/dL; n = 4760). In parallel with changes in Hb levels, donor smoking was associated with the receipt of additional RBC transfusions for irradiated (odds ratio [OR], 2.49; p = 0.01) but not unirradiated RBC units (OR, 1.10; p = 0.52). CONCLUSION Donor smoking was associated with reduced Hb increments and the need for additional transfusions in recipients of gamma‐irradiated RBC units. Additional research is needed to better understand interactions between donor, component, and recipient factors on efficacy measures of RBC transfusion.

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Timing of gamma irradiation and blood donor sex influences in vitro characteristics of red blood cells

Cited by 21 publications

References 31 publications

Guidelines on the use of irradiated blood components

Guidelines on the use of irradiated blood components

Quality Assessment of Established and Emerging Blood Components for Transfusion

Additive effects of blood donor smoking and gamma irradiation on outcome measures of red blood cell transfusion

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