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Randomized study of washing 40‐ to 42‐day‐stored red blood cells
Author(s) -
BennettGuerrero Elliott,
Kirby Brett S.,
Zhu Hongmei,
Herman Annadele E.,
Bandarenko Nicholas,
McMahon Timothy J.
Publication year - 2014
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/trf.12660
Subject(s) - hemolysis , clearance , red blood cell , medicine , potassium , whole blood , hemoglobin , andrology , point of care , surgery , chemistry , urology , pathology , organic chemistry
Background Pretransfusion washing of red blood cells ( RBC s) stored for a longer duration may have theoretical advantages but few data exist to support this practice. In many hospital settings, use of a point‐of‐care cell washer could conceivably be used to quickly wash allogeneic RBC s before transfusion. The purpose of this preliminary study was to compare a point‐of‐care device with a common blood bank device for washing longer‐stored RBC s. Study Design and Methods Forty RBC units stored for 40 to 42 days were randomized to washing with the COBE 2991 device ( T erumo BCT ; FDA ‐cleared for washing stored RBC s) or the C ell S aver E lite ( H aemonetics; FDA ‐cleared point‐of‐care device for processing and washing fresh autologous shed whole blood). Supernatant and unit RBC s from unwashed (baseline) and washed blood were assayed for potassium, lactate, intracellular ATP , percentage of RBC recovery, cell‐free hemoglobin, RBC microparticles, and RBC s were examined for susceptibility to hemolysis by physical stress. Results Both devices recovered a high percentage of RBC s and efficiently removed extracelluar potassium. Washing with the E lite resulted in significant increases in cell‐free Hb, percent hemolysis, and RBC microparticle production, whereas washing with the COBE 2991 did not (fold Δ = 2.1 vs. 1.0, 4.6 vs. 1.2, 2.0 vs. 1.1, respectively; p < 0.05). Hemolysis induced by physical stress was not altered by washing. Conclusion Although point‐of‐care washing of longer‐stored RBC s is appealing, these preliminary data suggest that transfusion of washed, longer‐stored units could result in potentially greater exposure to plasma free Hb. More data are needed before this practice can be routinely recommended.