X‐ and gamma‐irradiation have similar effects on the in vitro quality of stored red cell components

Abstract

Background: Blood components are irradiated to inactivate lymphocytes to prevent transfusion-associated graft versus host disease. As there are little data regarding the effects of X-irradiation on red blood cell components (RBCs), the in vitro quality of stored red cells (standard, pediatric, washed, and intrauterine transfusion [IUT]) following X-or gamma-irradiation was compared. Study design and methods: RBCs were pooled, split, and processed to produce standard (<14 days and < 5 days post-collection), pediatric (<5 days post-collection), washed (<14 days post-collection), or IUT RBCs (<5 days post-collection).Standard RBCs were either X-or gamma-irradiated (n = 10 pairs). A further 10 replicates were prepared by pooling and splitting three matched RBCs (X-, gamma-, and non-irradiated). All other RBCs were either X-or gamma-irradiated (n = 20 pairs). Red cell indices, hemolysis, potassium release, metabolism, microparticles, ATP, and 2,3-DPG were measured pre-irradiation and 6 h, 1, 2, 3, 7, 10, and 14 days post-irradiation, depending on the component type. Data were analyzed using two-way repeated measures ANOVA.Results: There were no significant differences in any in vitro quality measurements, with the exception of marginally higher potassium release in washed, IUT, and RBCs <5 days old (p < .0001) following X-irradiation.Both irradiation types increased generation of microvesicles, particularly in components that were older at the time of irradiation or stored for longer post-irradiation. Conclusion: X-and gamma-irradiation have similar effects on the in vitro quality of RBCs, indicating that either technology is suitable for blood component irradiation.

The compound effect of irradiation and familial pseudohyperkalemia on potassium leak from red blood cells

“…Moreover, at standard doses of irradiation for RCC there was no evidence of increased aggregation of proteins or membrane lipid peroxidation reported 28,29 . More recently, both gamma and x irradiation have been shown to cause an increase in microparticle formation in RCC, highly suggestive of membrane damage 30 . Altogether, the mechanism of increased permeability of cations across the RBC membrane post‐irradiation is unclear.…”

“…28,29 More recently, both gamma and x irradiation have been shown to cause an increase in microparticle formation in RCC, highly suggestive of membrane damage. 30 Altogether, the mechanism of increased permeability of cations across the RBC membrane post-irradiation is unclear.…”

The timing of gamma irradiation and its effect on cell‐free and microvesicle‐bound hemoglobin. The BEST collaborative study

“…While this lends support to the Council of Europe/CSA and BCSH guidelines, we believe the in vitro red cell quality data presented herein provides no cause for concern in regard to the in vivo efficacy of units irradiated in accordance with AABB guidelines. It is imperative that the findings of this study be extrapolated to X‐ray irradiated RCCs given that several jurisdictions are beginning to implement this method as it does not rely on a radioactive source 26 . Marks et al recently indicated that there is a high degree of equivalency between the in vitro effects of X‐ray and gamma irradiation on stored RCCs, suggesting that irradiation timing and postirradiation storage durations could have a similar impact between both methods of irradiation 26 .…”

“…It is imperative that the findings of this study be extrapolated to X‐ray irradiated RCCs given that several jurisdictions are beginning to implement this method as it does not rely on a radioactive source 26 . Marks et al recently indicated that there is a high degree of equivalency between the in vitro effects of X‐ray and gamma irradiation on stored RCCs, suggesting that irradiation timing and postirradiation storage durations could have a similar impact between both methods of irradiation 26 . Nevertheless, it remains valuable to assess whether the stark increase in free Hb associated with an extended postirradiation storage duration can impact vascular function in vivo, particularly in animal models of sickle cell disease.…”

Red cell extracellular vesicles and coagulation activation pathways

“…PRBC units may be irradiated to prevent graft-versus-host disease in high-risk recipient populations. In addition to increasing the hemolysis rate, both X and gamma irradiation may similarly increase sREV release [19][20][21]. The impact of the timing of irradiation is controversial.…”