Influence of 30 Gy Gamma Irradiation on the Quality of Red Blood Cell Concentrates in Several Storage Media

Abstract

Background: The transfusion-associated graft versus host disease (t-GvHD) occurring in immunosuppressed patients can be prevented by irradiation of red blood cell concentrates (RCCs) with gamma irradiation at a dose of 30 Gy prior to transfusion. The aim of this study was to investigate, whether the irradiation of leukocyte-depleted RCCs in different storage media (SAG-M, PAGGS-M, or Adsol) may cause deterioration of red blood cells (RBC), resulting in a shortened shelf life of the RCC. Material and Methods:According to manufacturing (manually, apheresis), storage medium used (SAG-M, PAGGS-M, Adsol) and processing of leukocyte depletion (filtered, nonfiltered), 192 RCCs were separated into 8 groups with 24 RCCs each. Each group was divided into two subgroups. One was irradiated (30 Gy), the other one was used as control. Until the end of shelf life, pH, the concentrations of Na⁺ , K⁺ , lactate, glucose, 2,3-diphosphoglycerate (2,3-DPG) and adenosine triphosphate (ATP), parameters of blood cell count, and external hemoglobin were measured every week. Results:The metabolic parameters did not show significant differences between nonirradiated and irradiated RCCs. K⁺ efflux and hemolysis were significantly higher in the irradiated RCCs after the first week of storage. The values of hemolysis remained below the recommended limit of 0.8% of the hemoglobin content of RCCs until the 28th day of storage. After 28 days of storage the mean values of K⁺ increased by 25% compared to the control samples at the end of shelf life. The mean corpuscular volume (MCV) was significantly higher in the irradiated RCCs with significant differences between the various storage media. Leukocyte-depleted RCCs showed partly smaller rates of hemolysis than unfiltered RCCs. Conclusions:The determined in vitro parameters of irradiated and leukocyte-depleted RCCs stored in SAG-M, PAGGS-M or Adsol revealed no significant quantitative changes until 28th day of storage compared to those of nonirradiated RCCs.

Altered intracellular purine nucleotides in gamma‐irradiated red blood cell concentrates

“…The haematocrit (Hct) is given as a percentage, fHb in mg/dl and Hb total (total haemoglobin) in g/dl [5].…”

“…This is crucial for patients receiving intensive chemotherapy, bone marrow grafts, in utero fetal transfusions or for patients with primary or secondary immunodeficiencies [2,4]. Numerous studies have investigated the effect of gamma irradiation on the quality of RBCs, and found enhanced K + efflux and Na + influx [5–8], reduced ATP levels [7–9] as well as increased free haemoglobin (fHb) and lactate dehydrogenase (LDH) levels in the storage medium of irradiated RBCs as a result of haemolysis [5,8,10]. Limited information is available, however, about the effect of gamma irradiation on the nucleotide metabolism of erythrocytes during storage.…”

Release of WBC‐derived IL‐1 receptor antagonist into supernatants of RBCs: influence of storage time and filtration

“…All values were in agreement with data from the literature. [13][14][15][16] At each time point of the study (before storage and at Weeks 1 to 7 of storage), supernatants of C-RBCs and F-RBCs were frozen at -70°C for IL-1RA determination. In addition, for determination of the total (free and cell-associated) IL-1RA content in RBC aliquots, a sequence of freezing (-70°C for 60 min) and thawing (37°C for 15 min) was followed three times to achieve complete cell lysis.…”

Susceptibility of oxidative stress on red blood cells exposed to gamma rays: Hemorheological evaluation

“…The dose recommended by the US Food and Drug Administration is a minimum of 25 Gy targeted to the midline of the container and a minimum dose of 15 Gy delivered to all other parts of the container [5]. Irradiation of red blood cells (RBCs), however, induces hematologic and biochemical RBC changes, such as K + efflux, Na + influx, reduced adenosine-5 -triphosphate (ATP) levels and increased free hemoglobin [6][7][8], and reduces viability in stored RBCs [9]. Therefore, the US Food and Drug Administration have recommended that RBCs should not be stored more than 28 days from the date of radiation exposure [10].…”