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Description and investigation of white particulate matter in additive solution‐1 red blood cell units
Author(s) -
Hillyer Christopher D.,
Roback John D.,
Hillyer Krista L.,
Josephson Cassandra D.,
Page Peter L.
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.1537-2995.2004.04036.x
Subject(s) - medicine , white blood cell , red blood cell , surgery
BACKGROUND: In January 2003, “white particulate matter” (WPM) was transiently observed in red blood cell (RBC) units collected predominately in the southeastern US. In this report, these events, their chronology, perti‐nent observations and investigations, and summaries and conclusions associated with WPM during the 2‐week observation period are described. CHRONOLOGY AND INVESTIGATIONS: On January 27, 2003, WPM was first identified in RBCs; by January 31, 2003, 110 RBC units containing WPM had been identified. Elective surgeries were postponed. Approxi‐mately 400 RBC units containing WPM were inspected in the blood center and characterized into four types: I, II, III, and IV. A variety of preparations of aspirated WPM were made, including light and electron microscopic sections. RESULTS AND CONCLUSIONS: The rate of WPM‐containing units was 1.67 percent (1 in 60 units), whereas the background incidence was less than 0.25 percent. Investigations revealed that WPM was composed of activated and nonactivated platelets (PLTs); no toxins, infectious agents, or agents of bioterrorism were iden‐tified. WPM correlated with certain variables studied, including PLT‐rich components that had been centrifuged with a “hard spin” before leukoreduction and manu‐factured in one vendor's collection sets. Because the increased rate of appearance of WPM was a transient phenomenon, it is not clear whether this is a newly noticed or a new and different phenomenon from “aggregates” observed in the past.