title: Haemolysis and sublethal injury of RBCs after routine blood bank manipulations.
abstract: OBJECTIVE
  To determine the extent of RBC sublethal injury in male donor units as measured by both the mechanical fragility index (MFI) and percentage haemolysis after RBCs underwent leucoreduction (LR), irradiation (IRRAD), and washing.
  
  
  BACKGROUND
  RBCs frequently undergo post-collection processing to meet certain recipient's special needs. The extent of haemolysis and sublethal injury following these interventions has not been fully characterised.
  
  
  METHODS
  Eight to ten day old male, AS-5 RBCs underwent either LR, IRRAD or washing. A control group of male, AS-5 RBCs were unmanipulated. The MFI, percent haemolysis, and plasma free haemoglobin (PFHb) were measured immediately after manipulation and, for a series of irradiated RBCs, 28 days after irradiation (IRRAD28).
  
  
  RESULTS
  The MFI of the washed units was significantly higher than unmanipulated, LR, IRRAD, IRRAD28 units (P < 0·0001). The percent haemolysis was highest in the IRRAD28 units (1·4%) followed by the washed units (0·74%); the other three units demonstrated significantly less haemolysis (P < 0·0001). The largest mean total amount of PFHb per unit was found in the IRRAD28 units (500·5 mg/unit) followed by the washed units (149·8 mg/unit); the mean total amount of PFHb in the three other types of units was significantly less than that found in both the IRRAD28 and washed units (P at least < 0·001).
  
  
  CONCLUSIONS
  There is a significant quantity of PFHb in IRRAD28 RBC units, and potentially in washed allogeneic RBC units. Clinical correlation is required to determine if this quantity of PFHb and the transfusion of potentially fragile RBCs causes adverse events.
authors.affiliation: Department of Pathology, University of Pittsburgh Medical Center, PA, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: Harm
authors.forename: J S
authors.initials: JS
authors.lastname: Raval
authors.forename: J
authors.initials: J
authors.lastname: Cramer
authors.forename: J H
authors.initials: JH
authors.lastname: Waters
authors.forename: M H
authors.initials: MH
authors.lastname: Yazer
mesh_terms: D001771:Blood Banks; D001793:Blood Preservation; D001803:Blood Transfusion / Q000379:methods*; D017707:Erythrocyte Transfusion / Q000379:methods; D004912:Erythrocytes / Q000473:pathology* / Q000528:radiation effects; D005720:Gamma Rays / Q000009:adverse effects*; D006086:Graft vs Host Disease / Q000517:prevention & control; D006454:Hemoglobins / Q000032:analysis; D006461:Hemolysis; D006801:Humans; D047589:Leukocyte Reduction Procedures; D008297:Male; D033081:Shear Strength; D013314:Stress, Mechanical
chemical_list: D006454:Hemoglobins