An in vitro comparison of cellular destruction and metabolic effects occurring in stored, leuco-reduced and irradiated red blood cells

Abstract

Biochemical and haematological changes occur in red blood cellular products during the recommended storage period of 35 to 42 days at 1°C to 6°C. The restriction of the sodium/potassium pump at specified temperatures result in low intracellular potassium ion levels while an increase in sodium ion levels are observed and acidosis occurs as a result of low pH concentrations due to glucose consumption. Structural and morphological changes occur such as the release of free haemoglobin, lactate dehydrogenase and potassium into the supernatant causing the formation of spheroechinocytes and osmotic fragility. All these factors negatively impact the rheological properties of blood. These changes that transpire in the red cells during the storage period are referred to as “storage lesions”. Transfusion-associated graft versus host disease is an immunological and often fatal adverse transfusion reaction with gamma irradiation of cellular blood products used as a preventative measure. Gamma irradiation exacerbates storage lesions and of particular concern has been the increased potassium levels resulting in neonatal and infant hyperkalaemia. The storage lesions occurring in non-irradiated red blood cellular products are well documented although the literature regarding its irradiated counterparts has been less studied. A study of this nature has not previously been done in Cape Town, South Africa.