Storing red cells at non-standard temperature
Authors:
P. Papoušek 1; S. Škodová 1; C. Andrýs 2; T. Suchý 3; P. Turek 4; L. Řehořová 1; R. Procházková 1,5
Authors‘ workplace:
Transfuzní oddělení, Krajská nemocnice Liberec, a. s.
1; Ústav klinické imunologie a alergologie, Fakultní nemocnice Hradec Králové
2; Oddělení kompozitních a uhlíkových materiálů, Ústav struktury a mechaniky hornin, Akademie věd České republiky, Praha
3; Transfuzní oddělení, Thomayerova nemocnice, Praha
4; Fakulta zdravotnických studií, Technická univerzita v Liberci
5
Published in:
Transfuze Hematol. dnes,26, 2020, No. 2, p. 124-130.
Category:
Original Papers
Overview
Background: Storage conditions of red cell transfusion components are set out by generally binding legal regulations. If these are not observed, the producer´s qualified person decides regarding their further use. The Society for Transfusion Medicine (STL) thus drew up Guideline No. 2015/11 defining the shortening of transfusion component usability according to the severity of non-observance. The aim of this work was to verify the impact of non-standard storage conditions on red cell transfusion components and to confirm whether the limits and their duration have been chosen appropriately.
Materials and methods: The impact of non-standard storage conditions on the quality of red cell transfusion components was verified using a temperature load test. The intensity of the load corresponded to the limits given in the STL guidelines. 40 transfusion units of Red Cells, Buffy Coat Removed in Additive Solution (BCR-AS) were included. On day 22–26, the transfusion components were exposed to the controlled temperature load – group A: 11 units, 15 °C, 6 hours, group B: 9 units, 13 °C, 6 hours and group C: 20 units, 13 °C, 48 hours. Haemolysis markers were measured on days 1, 22–26, 28, 35 and 42: free haemoglobin, K+, lactate dehydrogenase (LDH) and annexin V. In the control group (20 units of Red Cells, BCR-AS), free haemoglobin was determined on day 42.
Results: The level of free haemoglobin at the end of the storage period (day 42) did not exceed 0.8% of red cell mass in all units – on average 0.34% (A), 0.26% (B) 0.26% (C) and 0.26% in the control group. There was no statistically significant difference in the markers free haemoglobin and annexin V among the transfusion components A, B and C exposed to the temperature load. Groups B and C did not differ in the level of free haemoglobin, K+, LDH and annexin V. The level of K+ was statistically higher in group A compared to groups B and C.
Conclusion: The temperature limits given by STL are safe. The temperature load of 13 °C and 15 °C during storage only mildly affects quality and haemolysis after a temperature load was within safe limits. The degree of haemolysis measured using free haemoglobin did not differ among the groups. The level of K+ was influenced more by the temperature of the load than by its duration.
Keywords:
red cells – temperature – haemolysis – storage
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Labels
Haematology Internal medicine Clinical oncologyArticle was published in
Transfusion and Haematology Today
2020 Issue 2
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