Comparison of in vitro Characteristics of Leukodepleted Red Blood Cells (RBCs) Derived from Apheresis: Impact of Filter Performance

Novel apheresis systems allow collection of packed red blood cells (RBCs) either by double RBC apheresis (2-RBCA) or along with platelet (PLT) concentrates (RBCPLT). The objective of this study was to evaluate filtration performance in connection with in vitro storage quality of filtered RBCs derived from the devices Baxter Amicus (AM), Baxter Alyx (AX), Haemonetics MCS Plus (MCS+) and Gambro Trima Accel (TA). Materials and Methods: 66 2-RBCA (15 AX, 10 MCS+, 8 TA) and 33 RBC-PLT collections (15 AM, 9 MCS+, 9 TA) were analyzed. RBC filtration was performed at room temperature within 2-4 h of collection using white blood cell (WBC) reduction filters either integrated in the disposable sets or provided by a filtration device. In vitro parameters were measured after filtration and after 42 days of storage. Results: Except for 1 paired AX unit, all RBCs contained residual WBCs of < 1 × 106/unit. TA provided the best log reduction in WBCs and PLTs but demonstrated the longest filtration times and smallest RBC recoveries. AX and MCS+ had significantly shorter filtration times than AM, however, AM obtained the best RBC recoveries. After filtration, all packed RBCs showed similar in vitro characteristics. At the end of storage, lower values for hemolysis (TA) and ATP preservation (AX) were related to the post-filtration WBC amount, with TA demonstrating the lowest and AX the highest values. Conclusion: While differences in RBC loss were noted, satisfactory filter performance in terms of WBC and PLT removal was observed with most RBC units. In AX procedures, leukodepletion could be improved.