Serial assessment of biochemical parameters of red cell preparations to evaluate safety for neonatal transfusions.
OBJECTIVE
Neonatologists often prefer fresh blood (<7 days) for neonatal transfusions. The main concerns for stored RBCs are ex vivo storage lesions that undermine red cell functions and may affect metabolic status of neonatal recipients. This study was designed to evaluate serial in vitro changes of biochemical parameters in different RBC preparations during storage to consider for neonatal transfusions even after storage beyond one week.


METHODS
Twenty five units each of whole blood (CPDA-1 RBC, SAGM RBC) were selected for serial biochemical parameter assessment after each fulfilled the quality criteria (volume and haematocrit). These units were tested serially for supernatant potassium, pH, lactate, haemoglobin, glucose and red cell 2,3 diphosphoglycerate (2,3 DPG) up to 21 days of storage.


RESULTS
Within each group of RBC, rise in mean concentration of potassium, lactate and plasma haemoglobin from day 1 to 21 of storage was significant in CPDA-1 RBC having the highest levels at day 21. From day 3 to 21, SAGM RBC had higher mean pH value than CPDA-1 RBC though this difference was not statistically significant. SAGM RBC had highest mean glucose concentration during storage than other two types of red cell preparations (P<0.005). Within each group, fall in mean 2,3 DPG concentration from day 1 to 7 was significant (P<0.05). A positive correlation existed between mean plasma potassium and haemoglobin in all three types of red cells (r=0.726, 0.419, 0.605 for CPDA-1 RBC, SAGM RBC and whole blood respectively, P<0.005).


CONCLUSIONS
All the three red cell preparations tested revealed biochemical changes within acceptable limits of safety till 21 days of storage. CPDA-1 RBCs had the highest degree of these changes.
Department of Transfusion Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Somnath
S
Mukherjee
Neelam
N
Marwaha
Rajendra
R
Prasad
Ratti Ram
RR
Sharma
Beenu
B
Thakral
D019794:2,3-Diphosphoglycerate / Q000097:blood; D001786:Blood Glucose; D001800:Blood Specimen Collection / Q000379:methods*; D001803:Blood Transfusion / Q000379:methods / Q000592:standards*; D004912:Erythrocytes / Q000737:chemistry*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007194:India; D007231:Infant, Newborn; D019344:Lactic Acid / Q000097:blood; D011188:Potassium / Q000097:blood
D001786:Blood Glucose; D006454:Hemoglobins; D019794:2,3-Diphosphoglycerate; D019344:Lactic Acid; D011188:Potassium
Transfus Med Rev. 2006 Jan;20(1):34-44
16373186
Transfus Med Rev. 2009 Jan;23(1):55-61
19056034
Pediatrics. 1993 Mar;91(3):523-9
8441554
Transfusion. 2000 Dec;40(12):1528-40
11134575
Transfusion. 1993 Jul;33(7):606-9
8333025
Blood. 1962 Oct;20:485-91
13913090
Anesthesiology. 2006 May;104(5):911-20
16645441
J Lab Clin Med. 1969 May;73(5):722-33
5779258
Transfusion. 1990 Jul-Aug;30(6):565-70
2378026
Transfus Med Rev. 2002 Oct;16(4):283-95
12415514
Am J Dis Child. 1991 Aug;145(8):904-11
1858728
Asian J Transfus Sci. 2007 Jul;1(2):47-51
21938232
Nature. 1962 Jun 2;194:877-8
14478201