Increasing hemoglobin oxygen saturation levels in sickle trait donor whole blood prevents hemoglobin S polymerization and allows effective white blood cell reduction by filtration.
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.


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.


CONCLUSIONS
Storage of Hb AS whole blood in large-capacity oxygen-permeable bags increases oxygen tension and allows more effective WBC reduction by filtration.
Department of Tranfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland, USA. dstroncek@mail.cc.nin.gov
David F
DF
Stroncek
Karen M
KM
Byrne
Constance T
CT
Noguchi
Alan N
AN
Schechter
Susan F
SF
Leitman
D001565:Benzoates; D001704:Biopolymers; D001782:Blood Donors; D001793:Blood Preservation / Q000295:instrumentation; D002469:Cell Separation / Q000295:instrumentation / Q000379:methods*; D004058:Diffusion; D005374:Filtration; D006451:Hemoglobin, Sickle / Q000737:chemistry*; D006801:Humans; D007700:Kinetics; D007962:Leukocytes; D010100:Oxygen / Q000097:blood* / Q000494:pharmacology; D010108:Oxyhemoglobins / Q000032:analysis*; D010313:Partial Pressure; D010539:Permeability; D011138:Polytetrafluoroethylene; D011143:Polyvinyl Chloride; D019064:Product Packaging; D012805:Sickle Cell Trait / Q000097:blood*; D013997:Time Factors
D001565:Benzoates; D001704:Biopolymers; D006451:Hemoglobin, Sickle; D010108:Oxyhemoglobins; C036101:tri-(2-ethylhexyl)trimellitate; D011138:Polytetrafluoroethylene; D011143:Polyvinyl Chloride; D010100:Oxygen