The Effect of Pre-Storage Irradiation Blood on Quality of Red Blood Cells

Abstract

Background: Irradiation leads to increased storage lesions that may have harmful effects if transfused. Various storage lesions research has been carried out, and only very few articles are available on the impact of gamma irradiation on RBC storage lesions. Since there has been no study about finding the best time for irradiation, we decided to investigate the effect of irradiation on Red blood cells at different storage times after blood collection
 Materials and Methods: A total of 40 units of red blood cells divided into two groups, irradiated and nonirradiated. Irradiated RBCs were divided into three groups and each group containing ten units. The remaining ten units were considered as non-irradiated controls. Sampling from these irradiated and non-irradiated blood units was performed weekly to evaluate biochemical parameters and free plasma hemoglobin/Hemolysis index levels.
 Results: A significant increase in the mean values of plasma potassium, plasma Hb/Hemolysis index, and LDH, as well as a significant reduction in the mean value of 2,3 DPG and plasma sodium, were observed in both groups. Although the reduction of 2,3 DPG is extremely remarkable, it is compensated 24-48 hours after transfusion. Hence, the clinical result of 2,3-DPG-depleted RBC transfusion is known to be negligible. The irradiation group alteration was more notable than the non-irradiated one and the changes in the parameters were most significant in the group having been stored for a longer period after irradiation.
 Conclusion: Our investigation on the impact of gamma irradiation on RBCs makes it possible to suggest a storage time up to 28 days after irradiation is permissible and the best time for irradiation after blood collection is up to 14 days. It is pointed out that the blood unit should be transfused as soon as possible after the irradiation.

Irradiating stored blood and storing irradiated blood

“…They also pointed out that the blood unit should be transfused as soon as possible after the irradiation. [ 10 ] Results in our study showed the changes in various biochemical parameters during different days of the storage period. It is seen that plasma potassium, lactate, and LDH levels gradually increased during the storage period, whereas sodium and glucose levels decreased significantly over time.…”

Validated transport conditions maintain the quality of washed red blood cells

“…Irradiation has considerable effects on unit stability during storage. 18,19 We, therefore, included both irradiated and non-irradiated units in our study (6 of each). Importantly, because we sampled the units at multiple time points during the first 24 h post-washing this allowed for a unique analysis of the effects of irradiation during this critical interval.…”

“…Irradiation has considerable effects on unit stability during storage 18,19 . We, therefore, included both irradiated and non‐irradiated units in our study (6 of each).…”

“…Irradiation of RBC units prevents transfusion‐associated graft‐versus‐host disease (TA‐GVHD), particularly in severely immunocompromised patients, by preventing the proliferation of donor T lymphocytes 5 . However, irradiated RBC membranes are additionally weakened, with increased hemolysis and increased leakage of intracellular contents, including free Hgb and K + , into the extracellular space 5,18,19 . While washing these units has been shown to mitigate some of these effects, such as the increase in extracellular K + , 12 washed and irradiated units are held to the same time and temperature storage constraints as washed‐only units 5…”

“…5 However, irradiated RBC membranes are additionally weakened, with increased hemolysis and increased leakage of intracellular contents, including free Hgb and K + , into the extracellular space. 5,18,19 While washing these units has been shown to mitigate some of these effects, such as the increase in extracellular K + , 12 washed and irradiated units are held to the same time and temperature storage constraints as washed-only units. 5 To comply with regulatory guidance in the U.S. and to avoid safety and efficacy concerns, units that are returned to a transfusion service outside the approved transport temperature of 1°C-10°C are generally discarded, 5 contributing to costly product wastage.…”