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Increasing hemoglobin oxygen saturation levels in sickle trait donor whole blood prevents hemoglobin S polymerization and allows effective white blood cell reduction by filtration
Author(s) -
Stroncek David F.,
Byrne Karen M.,
Noguchi Constance T.,
Schechter Alan N.,
Leitman Susan F.
Publication year - 2004
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.0041-1132.2004.04086.x
Subject(s) - hemoglobin , whole blood , red blood cell , oxygen , white blood cell , chemistry , sickle cell trait , oxygen saturation , blood cell , medicine , surgery , immunology , biochemistry , disease , organic chemistry
BACKGROUND Red blood cell (RBC) components from donors with sickle cell trait (Hb AS) often occlude white blood cell (WBC) reduction filters. Techniques were investigated to successfully filter Hb AS donor blood by increasing the Hb oxygen saturation with storage bags and conditions suitable for transfusion products. STUDY DESIGN AND METHODS: Oxygenation kinetics were measured over 3 days in whole‐blood units stored in standard‐sized 600‐mL polyvinylchloride (PVC) bags and whole‐blood units divided into three equal parts and stored in standard‐sized blood bags made from PVC, tri‐2‐(ethylhexyl)trimellitate (CLX) plastic, or Teflon. The filterability of Hb AS blood stored for 3 days was tested with whole‐blood filters. RESULTS: Oxygen saturation levels did not increase in full whole‐blood units from donors without sickle cell trait during 3 days of storage in 600‐mL PVC bags. In divided Hb AS whole‐blood units stored for 3 days, oxygen saturation levels increased from baseline levels of 45 to 56, 66, and 94 percent after storage in 600‐mL PVC, CLX, and Teflon bags, respectively (n = 5, p < 0.02), and all components filtered completely. When full Hb AS whole‐blood units from eight donors were stored for 3 days in 1.5‐L CLX bags, all units filtered completely, but one had a high residual WBC count. CONCLUSION: Storage of Hb AS whole blood in large‐capacity oxygen‐permeable bags increases oxygen tension and allows more effective WBC reduction by filtration.