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Visual assessment of hemolysis in red blood cell units and segments can be deceptive
Author(s) -
Janatpour K.A.,
Paglieroni T.G.,
Crocker V.L.,
DuBois D.J.,
Holland P.V.
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.1537-2995.2004.03315.x
Subject(s) - hemolysis , medicine , whole blood , red blood cell , chromatography , surgery , immunology , chemistry
BACKGROUND: Blood components that appear hemo‐lyzed are discarded. However, visual inspection is subjec‐tive and criteria for excessive hemolysis are poorly defined. STUDY DESIGN AND METHODS: Packed RBCs (10 CPDA‐1, 10 Adsol) were collected. Half of each unit was leukoreduced. Plasma Hb was measured and compared in segments and units by three methods: 1) a HemoCue Plasma/Low Hb Photometer system; 2) a tetramethyl‐benzidine (TMB) chemical method, and 3) a free Hb visual comparator. RESULTS: Visual assessment tended to overestimate hemolysis. Chemical methods were comparable (r 2 = 0.894; HemoCue = 0.043 +[0.770]× TMB; n = 400; range, 0.01‐0.5 g/dL), although the mean plasma Hb (g/dL) for the HemoCue method was higher than that of the TMB method (0.12 vs. 0.10 g/dL, respectively; p < 0.001). No units would have been discarded based on a hemolysis level of at least 0.6 g/dL (approx. 1%) if measured by a chemical method. However, 50 percent of CPDA‐1 and 10 percent of Adsol units would have been discarded if only visual criteria were used. Leukoreduction did not increase plasma Hb levels. Discrepancies in plasma Hb levels were noted between units and their corresponding segments. CONCLUSION: Visual assessment of hemolysis can result in unnecessary wastage of blood components. HemoCue offers an alternative, objective method to assess plasma Hb in the setting of blood collection and processing facilities for routine quality control and process validation, and may aid in the development of objective criteria for excessive hemolysis in blood components.