title: Characteristics of prion-filtered red cells suspended in pathogen-inactivated plasma (MB treated or solvent-detergent treated) for neonatal exchange transfusion.
abstract: OBJECTIVE
  Neonates undergoing exchange transfusion require <5-day-old red cells suspended in plasma. This study assesses the effect of replacing the saline, adenine, glucose and mannitol (SAGM) of prion reduced (P-Capt) red cells with either methylene blue-treated plasma (MBTFFP) or OctaplasLG to reduce the risk of variant Creutzfelt-Jakob disease transmission.
  
  
  METHODS
  Twenty leucoreduced red cell units in SAGM were prion reduced on day 1. The SAGM was replaced by MBTFFP (n=10) or OctaplasLG (n=10). The units were irradiated and stored at 4°C for 24 h. A further 20 units were stored for 5 days before being processed as above. Haemolysis (%), potassium, ATP, 2,3-DPG and plasma proteins were measured.
  
  
  RESULTS
  Haemolysis remained low (≤0·16%). Following irradiation and storage, red cells in both types of plasma showed similar changes in potassium and ATP concentrations. The 2,3-DPG concentrations were well maintained although lower in red cells in OctaplasLG compared with those in MBTFFP (4·79 vs. 6·83 μmoles/g Hb on day 6). MBTFFP contained lower concentrations of fibrinogen, FV and FVIII. In OctaplasLG, alpha-2-antiplasmin was approximately 0·4 U/ml lower than in MBTFFP. After 24 h at 4°C, free protein S in OctaplasLG fell from 0·82 to 0·57 IU/ml. Other plasma proteins, in both types of plasma, were stable.
  
  
  CONCLUSIONS
  Red cells in both types of plasma demonstrated similar storage characteristics. The plasma proteins, except protein S in OctaplasLG, were stable over 24 h at 4°C in both types of plasma, and low FVIII concentrations were noted in the MBTFFP (group O) units used.
authors.affiliation: Components R&D Group, National Science Laboratory, SNBTS, Edinburgh, UK. valerie.hornsey@nhs.net
authors.forename: V S
authors.initials: VS
authors.lastname: Hornsey
authors.forename: C
authors.initials: C
authors.lastname: Casey
authors.forename: K
authors.initials: K
authors.lastname: McColl
authors.forename: H
authors.initials: H
authors.lastname: Young
authors.forename: O
authors.initials: O
authors.lastname: Drummond
authors.forename: L
authors.initials: L
authors.lastname: McMillan
authors.forename: A
authors.initials: A
authors.lastname: Morrison
authors.forename: C V
authors.initials: CV
authors.lastname: Prowse
mesh_terms: D019794:2,3-Diphosphoglycerate / Q000097:blood; D000255:Adenosine Triphosphate / Q000097:blood / Q000378:metabolism; D001793:Blood Preservation / Q000379:methods*; D001798:Blood Proteins / Q000187:drug effects / Q000378:metabolism; D003902:Detergents / Q000494:pharmacology*; D004203:Disinfection / Q000379:methods*; D017707:Erythrocyte Transfusion; D004912:Erythrocytes / Q000166:cytology / Q000187:drug effects / Q000378:metabolism*; D005340:Fibrinogen / Q000187:drug effects / Q000378:metabolism; D005374:Filtration / Q000379:methods; D006461:Hemolysis / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D008751:Methylene Blue / Q000494:pharmacology*; D010951:Plasma Exchange / Q000379:methods*; D011188:Potassium / Q000097:blood / Q000378:metabolism; D011328:Prions; D012997:Solvents / Q000494:pharmacology; D000979:alpha-2-Antiplasmin / Q000187:drug effects / Q000378:metabolism
chemical_list: D001798:Blood Proteins; D003902:Detergents; D011328:Prions; D012997:Solvents; D000979:alpha-2-Antiplasmin; D019794:2,3-Diphosphoglycerate; D000255:Adenosine Triphosphate; D005340:Fibrinogen; D011188:Potassium; D008751:Methylene Blue