title: Primary prevention of pediatric lead exposure requires new approaches to transfusion screening.
abstract: OBJECTIVE
  To facilitate further assessment of transfusion-associated lead exposure by designing a procedure to test packed red blood cells (pRBCs) prepared for transfusion.
  
  
  METHODS
  The relationship between pRBCs and whole blood lead concentration was investigated in 27 samples using a modified clinical assay. Lead concentrations were measured in 100 pRBC units.
  
  
  RESULTS
  Our sample preparation method demonstrated a correlation between whole blood lead and pRBC lead concentrations (R(2) = 0.82). In addition, all 100 pRBC units tested had detectable lead levels. The median pRBC lead concentration was 0.8 μg/dL, with an SD of 0.8 μg/dL and a range of 0.2-4.1 μg/dL. In addition, after only a few days of storage, approximately 25% of whole blood lead was found in the supernatant plasma.
  
  
  CONCLUSIONS
  Transfusion of pRBCs is a source of lead exposure. Here we report the quantification of lead concentration in pRBCs. We found a >20-fold range of lead concentrations in the samples tested. Pretransfusion testing of pRBC units according to our proposed approach or donor screening of whole blood lead and selection of below-average units for transfusion to children would diminish an easily overlooked source of pediatric lead exposure.
authors.affiliation: Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Gehrie
authors.forename: Amaris
authors.initials: A
authors.lastname: Keiser
authors.forename: Sheila
authors.initials: S
authors.lastname: Dawling
authors.forename: James
authors.initials: J
authors.lastname: Travis
authors.forename: Frederick G
authors.initials: FG
authors.lastname: Strathmann
authors.forename: Garrett S
authors.initials: GS
authors.lastname: Booth
mesh_terms: D058731:Blood Safety / Q000379:methods*; D004785:Environmental Pollutants / Q000097:blood*; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D004912:Erythrocytes / Q000737:chemistry; D006801:Humans; D007854:Lead / Q000097:blood*; D020264:Lead Poisoning, Nervous System, Childhood / Q000209:etiology / Q000517:prevention & control*; D013058:Mass Spectrometry; D010949:Plasma / Q000737:chemistry
chemical_list: D004785:Environmental Pollutants; D007854:Lead
keywords: CDC; Centers for Disease Control and Prevention; ICP-MS; Inductively coupled plasma mass spectrometry; Packed red blood cell; VUMC; Vanderbilt University Medical Center; WHO; World Health Organization; pRBC