Quality control of blood irradiation with a teletherapy unit: damage to stored red blood cells after cobalt‐60 gamma irradiation

Góes, Evamberto Garcia de; Ottoboni, M.A.; Palma, Patrícia Vianna Bonini; Morais, F. R.; Pelá, Carlos Alberto; Borges, J.C.; Covas, Dimas Tadeu

doi:10.1111/j.1537-2995.2007.01527.x

Cited by 14 publications

(11 citation statements)

References 43 publications

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“…These data are consistent with other findings that irradiation (with a dose lower than in our study; 25 Gy), filtration, and combined irradiation and filtration before storage can cause significant damage in RBCs and intensify the RBC storage lesions such as increased free Hb and K + [31]. Similar to our results, the increase in free Hb plasma levels in the irradiated RBC units (30 Gy) was found less evident during the first days of storage [7]. …”

Section: Discussionsupporting

confidence: 83%

“…In consistence with our results, it was demonstrated that prolonged storage (up to 45 days) of the RBCs irradiated with a cobalt teletherapy unit (30 and 40 Gy) resulted in loss of membrane phospholipid asymmetry, exposing PS on the cells' surface in a time- and dose-dependent manner. The magnitude of this effect did not seem to be clinically relevant [7]. …”

Section: Discussionmentioning

confidence: 99%

“…Gamma irradiation of the RBC transfusion units (25-50 Gy) is the procedure of choice to prevent transfusion-associated graft-versus-host disease (TA-GvHD) [7,8]. However, when RBCs are irradiated, a notable alteration of their properties has been noted accounting for a shortened RBC transfusion unit shelf life [9,10,11,12].…”

Section: Introductionmentioning

confidence: 99%

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Influence of Pre-Storage Irradiation on the Oxidative Stress Markers, Membrane Integrity, Size and Shape of the Cold Stored Red Blood Cells

Antosik

Czubak

Gajek

et al. 2015

Transfus Med Hemother

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Background: To investigate the extent of oxidative damage and changes in morphology of manually isolated red blood cells (RBCs) from whole blood, cold stored (up to 20 days) in polystyrene tubes and subjected to pre-storage irradiation (50 Gy) and to compare the properties of SAGM-preserved RBCs stored under experimental conditions (polystyrene tubes) with RBCs from standard blood bag storage. Methods: The percentage of hemolysis as well as the extracellular activity of LDH, thiobarbituric acid-reactive substances, reduced glutathione (GSH), and total antioxidant capacity (TAC) were measured. Changes in the topology of RBC membrane, shape, and size were evaluated by flow cytometry and judged against microscopy images. Results: Irradiation caused significant LDH release as well as increased hemolysis and lipid peroxidation, GSH depletion, and reduction of TAC. Prolonged storage of irradiated RBCs resulted in phosphatidylserine exposure on the cell surface. By day 20, approximately 60% of RBCs displayed non-discoid shape. We did not notice significant differences in percentage of altered cells and cell volume between RBCs exposed to irradiation and those not exposed. Conclusion: Irradiation of RBC transfusion units with a dose of 50 Gy should be avoided. For research purposes such as studying the role of antioxidants, storage of small volumes of RBCs derived from the same donor would be more useful, cheaper, and blood-saving.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

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Influence of Pre-Storage Irradiation on the Oxidative Stress Markers, Membrane Integrity, Size and Shape of the Cold Stored Red Blood Cells

Antosik

Czubak

Gajek

et al. 2015

Transfus Med Hemother

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“…Therefore, identical concentrations of both antioxidants were applied. Hemolysis, and the protection by antioxidants was more evident at day 20 which is consistent with findings reported by others [30,31]. At concentrations up to 3.125 mmol/l, Trolox was somewhat more effective than mannitol in protecting against progressive hemolysis.…”

Section: Discussionsupporting

confidence: 81%

Vitamin E Analogue Protects Red Blood Cells against Storage-Induced Oxidative Damage

Antosik

Czubak

Cichoń

et al. 2018

Transfus Med Hemother

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Background: To investigate i) the effects of Trolox® or mannitol, which represent two different classes of antioxidants, on oxidative changes generated in manually isolated red blood cells (RBCs) from citrate-phosphate-dextrose (CPD) preserved whole blood, followed by up to 20 days refrigerated storage, and ii) whether Trolox supplemented to the blood bank-manufactured saline-adenine-glucose-mannitol (SAGM) preserved RBC units would offer better storage conditions compared with SAGM alone. Methods: The percentage of hemolysis and extracellular activity of lactate dehydrogenase (LDH) was measured to assess RBC membrane integrity. Lipid peroxidation, reduced glutathione (GSH) levels and total antioxidant capacity (TAC) were quantified by thiobarbituric acid-reactive substances (TBARS), Ellman's reagent and 2, 2'-azinobis-(3-ethylbenzothiazoline-6-sulfonate) (ABTS.+) based assay, respectively. Results: Trolox was little more effective than mannitol in protecting against progressive RBC hemolysis. Trolox (0.125-3.125 mmol/l) inhibited storage-induced leakage of LDH, lipid peroxidation, and to a lesser extent GSH depletion. Mannitol at these concentrations neither inhibited TBARS formation nor prevented GSH depletion. RBC units stored in SAGM-Trolox had significantly lower hemolysis, LDH leakage, and lipid peroxidation level compared to RBCs stored in SAGM. Conclusion: There is evidence of the beneficial effects of supplementing RBC-additive solutions with membrane-interacting antioxidants such as vitamin E analogues.

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“…Therefore, the finding by Leitner and coworkers of critically enhanced in vitro hemolysis in stored irradiated units probably resembles the well‐known enhancement of the in vitro hemolysis rate in underfilled components 24 . Other reports on quality control of blood irradiation also divided RBC units into unusually small aliquots, which do not resemble the normal filling status of RBCs to study differences between groups without the bias of biologic variabilities 25 …”

Section: Discussionmentioning

confidence: 89%

Influence of prestorage leukoreduction and subsequent irradiation on in vitro red blood cell (RBC) storage variables of RBCs in additive solution saline‐adenine‐glucose‐mannitol

et al. 2008

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BACKGROUND:There exists only very few data on in vitro and in vivo effects of gamma irradiation of red blood cells (RBCs) that have been leukoreduced by filtration before a subsequent irradiation. Reported studies reflect neither the current Food and Drug Administration (FDA) nor the European recommendations on timing of irradiation and subsequent storage. STUDY DESIGN AND METHODS:We studied 40 RBC units that were prepared from inline filtered whole blood and 40 RBC units that were filtered after component separation. All RBCs were stored in the additive solution saline-adenine-glucose-mannitol and leukoreduced on the collection day. In both groups, 20 components were irradiated on Day +14 with 30 Gy, and 20 served as nonirradiated controls. In vitro evaluation of both irradiated and nonirradiated RBC units was performed before and after irradiation on Days +1, +7, +14, +21, +28, +35, and +42 from the collection day. RESULTS: Gamma irradiation induced enhanced leakage of potassium ions and lactate dehydrogenase and an enhanced in vitro hemolysis rate in the irradiated components. However, in vitro hemolysis rate of both nonirradiated and irradiated components was remarkably lower than 0.8 percent, and the preservation of adenosine triphosphate over 42 days was satisfying. CONCLUSIONS: This study reflects the current FDA and European recommendations on timing of irradiation and subsequent storage. Our findings together with recent results of other investigations on the effect of gamma irradiation on leukoreduced RBCs allow the proposal that a storage time up to 28 days after irradiation is allowable.

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Quality control of blood irradiation with a teletherapy unit: damage to stored red blood cells after cobalt‐60 gamma irradiation

Cited by 14 publications

References 43 publications

Influence of Pre-Storage Irradiation on the Oxidative Stress Markers, Membrane Integrity, Size and Shape of the Cold Stored Red Blood Cells

Influence of Pre-Storage Irradiation on the Oxidative Stress Markers, Membrane Integrity, Size and Shape of the Cold Stored Red Blood Cells

Vitamin E Analogue Protects Red Blood Cells against Storage-Induced Oxidative Damage

Influence of prestorage leukoreduction and subsequent irradiation on in vitro red blood cell (RBC) storage variables of RBCs in additive solution saline‐adenine‐glucose‐mannitol

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