Evaluating the quality of X-ray irradiated deglycerolized red blood cells stored in saline-adenosine-glucose-mannitol additive solution.

Abstract

Background: Rare phenotype red blood cells (RBCs) are routinely cryopreserved and stored at -80°C for over 10 years. Upon thawing and deglycerolization, RBCs resuspended in saline-adenosine-glucose-mannitol (SAGM) have a limited 24-h shelf-life. There is a lack of international consensus as to whether irradiation of deglycerolized RBCs is necessary for patients at risk of transfusion-associated graft-versus-host disease. The aim of this study was to evaluate the quality of X-ray irradiated deglycerolized RBCs resuspended in SAGM.

Study design and methods: Matched RBC components (n = 21 pairs) were glycerolized with 40% glycerol, frozen at -80°C, deglycerolized using an ACP-215 cell washer, and resuspended in SAGM. One of each pair was X-ray irradiated post-deglycerolization, while the other remained untreated (control). RBCs were sampled pre-freeze and immediately, 24-, 48-, and 72-h post-irradiation. Quality indicators including RBC indices, metabolic, and biochemical parameters were measured.

Results: There were no significant differences between X-irradiated and control groups for volume, hemoglobin (Hb), hematocrit, or supernatant Hb immediately post-thaw. Hemolysis was higher in X-irradiated deglycerolized RBCs (0.35 ± 0.14%) than controls (0.32 ± 0.05%) after 24-h (p = 0.077). Potassium (K⁺) release was significantly higher in X-irradiated RBCs compared to controls after 24-h (6.26 ± 0.95 mmol/unit vs. 3.21 ± 1.01 mmol/unit respectively; p < .001).

Discussion: X-irradiation had a significant effect on K⁺ release from deglycerolized RBCs during storage, and to a lesser extent, hemolysis. The K⁺ and hemolysis levels at 24 h post-irradiation were acceptable, as were the other quality parameters, indicating that X-irradiation of these components is feasible.