Potassium Loss from Leucodepleted Red Cells following γ‐Irradiation

Abstract

We have carried out a study to determine the effect of high-efficiency pre-storage leucodepletion by filtration upon the red-cell storage parameters potassium, sodium and glucose after y-irradiation to 34.5 Gy.The transfusion of viable T-cells from donor blood products can lead to engraftment and transfusion-associated graft-versus-host disease. This rare but usually fatal complication can be prevented by yirradiation of the blood product to a minimum of 25 Gy to prevent T-cell mitosis and engraftment [I]. A side-effect of y-irradiation is an increase of potassium leakage from red cells which occurs during storage. This phenomenon is of particular importance when the transfusion is of a large volume and given to a neonate or to a patient with a pre-existing renal problem or hyperkalaemia. However, the cause of accelerated potassium leakage remains uncertain. It has been postulated that the mechanism may be indirect, involving granulocyte proteases.To test this hypothesis, 19 units of CPD-A1 red cells were produced by centrifugation of CPD-AI whole blood at 2,174g for 2.5 min followed by expression of platelet-rich plasma to leave the concentrated red cells. The packs were sampled (5 ml) and stored at 2 4°C for 48 h at which time 10 units were leucodepleted using Pall BPF-4 filters. Mean residual leucocytes in the filtered and control non-filtered units were 3 . 7~ 105/unit and 2 . 8 6~ lO'/unit, respectively. Filtration time was 17:03+2:32 min. All 19 units were then y-irradiated to a dosage of 34.5 Gy delivered over 7 min. All units were sampled before and after filtration (if applicable) and irradiation, followed by sampling at 3,7, 14, 21, 28, 35 and 42 days. The supernatant was removed and stored at Fig. 1. Potassium release form y-irradiated CRC. Data represent mean f 1 SD. KARCER Q 1996 S . Karger AG, Basel E-Mail kargurer karger.ch cnU L~~ L I m r I I ? A Perkins HA: Should all blood from related donors be irradiated? (editorial). Transfusion 1992;32:302-303. Rivet C, Baxter A, Rock G : Potassium levels in irradiated blood. Transfusion 1989;29: 185. Ramirez AM, Woodfield GD, Scott R, McLachlan J: High potassium levels in stored irradiated blood. Transfusion 1987;27:44+445. Walther-Wenker G . Horstman E, Muller N: Optimised red-cell concentrates for the transfusion of premature neonates (abstract FP02-P7). 26th DGTl Congr 1993. Heaton WAL: Effects of 3-5 log,, pre-storage leucocyte depletion on redcell storage and metabolism. Br J Heaniatol 1994;87:363-368. Chambers LA, Wissel M, Price N, Gunter J: Effects of filtration on potassium levels in previously irradiated and stored CPDA-I packed cells. Transfusion 1993;33(suppl.):335S36

Viability and in vitro properties of AS‐1 red cells after gamma irradiation

“…Furthermore, it should be noted that marked changes in potassium and sodium transport occur when RBCs are stored at 1 to 6°C without any prior irradiation, 2–7,18 and that previously stored RBCs have been shown to regain potassium and lose sodium after transfusion 19 . In connection with the increased use of white cell‐reduced RBCs, a recent study showed that filtered and unfiltered RBCs lost potassium in a comparable manner during storage following gamma radiation 20 . In summary, the data presented in this report identify a series of conditions (irradiation times and postirradiation storage periods) under which RBC properties are minimally influenced in comparison to untreated control RBCs, except for supernatant potassium and sodium levels.…”

Influence of late irradiation on the in vitro RBC storage variables of leucoreduced RBCs in SAGM additive solution

“…The gamma irradiation primarily targets nucleic acids of lymphocytes, which contaminate cellular blood components. However, the irradiation of red blood cells (RBCs) causes also alterations of these cells, impairs the membrane integrity, cell deformability, and elasticity, leads to increased leakage of potassium ions, accelerated loss of intracellular purine nucleotides, and accelerated in vitro haemolysis [4–10]. The in vivo recovery of transfused irradiated RBCs is decreased [11].…”

Modern Approaches To Quality Control

“…If the MTBF of the new product is 5 times that of the basic (Φ=5), replacement is beneficial; at Φ=2.5 it does no harm; but at Φ=1.5 it is unacceptable. These findings follow from the OC nTr of a non-truncated SPRT with α==0.1, d=2, Φ 0 =5 (Figure 13), constructed as per ( 23) - (24). The apparatus are operated in sets of 28 items, so that conditions within a set are practically uniform.…”