Active cooling of whole blood to room temperature improves blood component quality

BACKGROUND: Many countries use cooling plates to actively cool collected whole blood (WB) to room temperature. Until now, no paired comparison had been performed, and it was our aim to compare the effect of active versus no active cooling on the in vitro quality of WB and subsequently prepared blood components. STUDY DESIGN AND METHODS: Two units of WB were pooled and divided shortly after donation. One unit was placed under a butane‐1,4‐diol plate to obtain active cooling; the other was placed in an insulated box with other warm units to mimic worst‐case holding conditions. WB was held overnight and processed into a white blood cell (WBC)‐reduced red blood cells (RBCs), buffy coat (BC), and plasma. The BCs were further processed into platelet (PLT) concentrates. RBCs were stored for 42 days, and PLT concentrates for 8 days (n = 12 paired experiments). RESULTS: After overnight storage, ATP content of the RBCs was 4.9 ± 0.3 µmol/g Hb for actively cooled WB versus 4.5 ± 0.4 µmol/g Hb for not actively cooled WB (p < 0.001). On Day 42 of storage, RBCs prepared from this WB contained 3.1 ± 0.3 µmol ATP/g Hb with active cooling versus 2.6 ± 0.3 µmol/g Hb without (p < 0.001). Hemolysis on Day 42 was 0.35 ± 0.08% with active cooling and 0.67 ± 0.21% without (p < 0.001). No effect was observed on the in vitro quality of plasma, BC, or PLT concentrates. CONCLUSIONS: Active cooling of WB results in improved ATP levels and less hemolysis in WBC‐reduced RBCs, although the clinical implications are unclear. It has no effect on the in vitro quality of plasma or PLT concentrates.     

Characterization of blood components prepared from whole-blood donations after a 24-hour hold with the platelet-rich plasma method

BACKGROUND: The preparation of platelet (PLT) concentrates (PCs) from PLT-rich plasma (PRP) requires that whole blood (WB) be processed within 8 hours of collection. Increasing WB storage time to 24 hours would be logistically attractive. This study compares the in vitro quality of blood components prepared from WB stored for 8 and 24 hours at room temperature before processing with the PRP method. STUDY DESIGN AND METHODS: WB units were collected from ABO-matched blood donors. To reduce individual variations, paired donations were drawn in parallel, pooled, and split back in the collection bag. One unit was held for 6 to 8 hours and the other for 22 to 24 hours at 20 to 24 degrees C. Prestorage leukoreduced components were prepared with the PRP as intermediate product and analyzed during storage. RESULTS: RBC units prepared after an 8- or 24-hour hold were comparable in terms of hemolysis, sodium, pH, and ATP levels. RBC 2,3- diphosphoglycerate (2,3-DPG) was significantly lower in RBCs prepared from 24-hour hold donations immediately after processing but not after 20 days of storage. Residual white blood cells were approximately fivefold higher (p < 0.05) in 24-hour RBC units. For PCs, measurements for glucose, ATP, lactate, pH, extent of shape change, hypotonic shock response, and CD62p activation were similar. No differences were observed in the von Willebrand factor, factor (F)V, FVIII, and fibrinogen content of fresh-frozen plasma. CONCLUSIONS: The decrease in FVIII and RBC 2,3-DPG can be acceptable as a compromise to improve blood component logistics, but leukoreduction efficiency must be improved before considering the adoption of an overnight storage of WB before PRP processing.     

Storage of platelet concentrates from pooled buffy coats made of fresh and overnight-stored whole blood processed on the novel Atreus 2C+ system: in vitro study

BACKGROUND: The Atreus 2C+ system (Gambro BCT) automatically separates whole blood (WB) into buffy coat (BC), red blood cells (RBC), and plasma and transfers the components into separate containers. After processing with the Atreus, 4 to 6 BC units can be pooled and processed into leukoreduced platelets (PLTs) by use of the automated OrbiSac BC system (Gambro BCT). The aim of our in vitro study was to investigate the effects of holding either WB or BC overnight before preparation of PLTs by use of the Atreus 2C+ system for BC preparation. A standard routine procedure involving conventional blood containers for the preparation of BC combined with the OrbiSac process (top-and-top system; Terumo) was used as a reference. STUDY DESIGN AND METHODS: WB was either processed within 8 hours after collection ("fresh blood") or stored overnight before processing. WB units were separated into BC, RBC, and plasma units and transferred into individual containers. Either the BC or the WB units rested overnight at 22 +/- 2 degrees C. Six ABO-identical BCs, obtained from either fresh or overnight-stored WB, were pooled and processed with the OrbiSac BC system to obtain leukoreduced PLTs. In total, 20 Atreus and 10 reference (leukoreduced PLTs) samples were analyzed for various in vitro variables during the 7-day storage period. RESULTS: No significant difference in glucose consumption, lactate production, mean PLT volume, LDH activity, bicarbonate, ATP, RANTES, and the expression of CD62p and CD42b between groups was detected. pH was maintained at greater than 7.0 (Day 7). Swirling remained at the highest levels (score, 2) for all units throughout storage. CONCLUSION: PLTs derived from BCs, obtained from either fresh or overnight-stored WB processed on the novel automated Atreus 2C+ system, were equivalent to control PLTs with regard to PLT in vitro characteristics during 7 days of storage. Stable recovery of PLTs and satisfactory PLT content according to current standards were also found.     

Overnight storage of whole blood: a comparison of two designs of butane-1,4-diol cooling plates

BACKGROUND: Whole blood (WB) can be stored overnight before processing, provided that it is quickly cooled to room temperature (20-25 degrees C), for example, with butane-1,4-diol plates. A new design of cooling plates became available (CompoCool-WB, Fresenius HemoCare), where WB must be placed vertically against the plates, versus placing of WB under plates in the current version (Compocool). This study compared cooling efficiency and in vitro quality of plasma and of stored white cell (WBC)-reduced red cells (RBCs) from overnight-stored WB, cooled with either of the systems. STUDY DESIGN AND METHODS: Temperature curves following cooling with Compocool or CompoCool-WB were studied with a 25 percent glycerol solution as simulated WB. WB from voluntary donors was cooled with Compocool or CompoCool-WB, stored overnight at room temperature, centrifuged, and separated into components. WBC-reduced RBCs in SAGM were stored until Day 42 with measurement of in vitro parameters (n=23/group). RESULTS: Simulated WB reached a temperature of less than 25 degrees C after 2:15+/-1:04 hours for Compocool versus 1:39+/-0:38 hours for CompoCool-WB (p=0.02). On Day 35, RBCs had a hemolysis of 0.3+/-0.2 percent in both groups, and ATP levels were 3.3+/-0.5 and 3.6+/-0.5 micromol per g hemoglobin for Compocool and CompoCool-WB, respectively (not significant). Factor VIII content in plasma was 1.05+/-0.25 and 0.97+/-0.18 IU per mL for Compocool and CompoCool-WB, respectively. CONCLUSION: WB can be cooled to room temperature within 2 hours with both Compocool and CompoCool-WB butane-1,4-diol plates, improving temperature uniformity in WB donations. Application of either design for overnight storage of WB at room temperature had no adverse effects on the composition of subsequently prepared blood components.     

Storage of interim platelet units for 18 to 24 hours before pooling: in vitro study

BACKGROUND: The Atreus 3C system (CaridianBCT) automatically produces three components from whole blood (WB), a red blood cell (RBC) unit, a plasma unit, and an interim platelet (PLT) unit (IPU) that can be pooled with other IPUs to form a PLT dose for transfusion. The Atreus 3C system also includes a PLT yield indicator (PYI), which is an advanced algorithm that provides an index that is shown to correlate well with the amount of PLTs that finally end up in the IPU bag. The aim of our in vitro study was to compare the effects of holding WB overnight versus processing WB fresh (2‐8 hr), both with 18‐ to 24‐hour storage of the IPUs before pooling into a transfusable PLT dose. STUDY DESIGN AND METHODS: WB was processed either fresh (within 8 hr after collection, Atreus F) or after overnight storage (14‐24 hr, Atreus S) without agitation at 22 ± 2°C. After a subsequent resting time of 18 to 24 hours on a flat‐bed shaker, five IPUs were selected for pooling with 200 mL of PAS II for in vitro quality assessments during a 7‐day storage period (n = 10 in each arm). IPUs were selected for pooling using the PYI of the Atreus 3C system. RESULTS: During storage, the glucose concentration was lower (p < 0.05) and the lactate concentration was higher (p < 0.05) in Atreus S pools, but no differences in the glucose consumption rate were noted. Adenosine triphosphate levels and hypotonic shock response reactivity were higher in Atreus S (p < 0.05). No significant differences in PLT counts, contents, mean PLT volume, lactate dehydrogenase, pO₂, pCO₂, extent of shape change, and CD62P between groups were detected. pH was maintained higher than 6.8 (Day 7). With exception of 2 units in the Atreus S arm, swirling remained at greater than 2 in all units at all times. CONCLUSION: Our results suggest that PLTs prepared from fresh or overnight‐stored WB and pooled after 18 to 24 hours meet necessary in vitro criteria without any relevant differences between both groups. Using the PYI, comparable yields can be obtained between WB processed within 2 to 8 hours and WB stored overnight.     

The effect of whole-blood storage time on the number of white cells and platelets in whole blood and in white cell-reduced red cells

BACKGROUND: Whole blood (WB) can be stored for some time before it is processed into components. After introduction of universal white cell (WBC) reduction, it was observed that longer WB storage was associated with more residual WBCs in the WBC-reduced red cells (RBCs). Also, weak propidium iodide (PI)-positive events were observed in the flow cytometric WBC counting method, presumably WBC fragments. The effect of storage time on the composition of WB and subsequently prepared WBC-reduced RBCs was studied. STUDY DESIGN AND METHODS: WB was collected in bottom-and-top collection systems with inline filters, obtained from Baxter, Fresenius, or MacoPharma. Units were stored at room temperature and separated into components in 4-hour intervals between 4 and 24 hours after collection. RBCs were WBC-reduced by inline filtration (approx. 50/group). RESULTS: Platelet (PLT) counts were lower in WB stored for 4 to 8 hours compared to 20 to 24 hours (mean +/- SD): 79 +/- 31 versus 102 +/- 30 for Baxter (p < 0.01); 91 +/- 31 versus 101 +/- 35 for Fresenius (not significant); and 73 +/- 47 versus 97 +/- 31 (all x 10(9) per unit) for MacoPharma (p < 0.01), respectively. The median residual WBC counts in WBC-reduced RBCs for WB stored for 4 to 8 and 20 to 24 hours were 0.03 versus 0.17 for Baxter (p < 0.001), 0.00 versus 0.06 for Fresenius (p < 0.001), and 0.13 versus 0.26 (all x 10(6) per unit) for MacoPharma (not significant), respectively. All WBC-reduced RBCs contained fewer than 5 x 10(6) WBCs per unit. A longer storage time of WB was associated with more weak PI-positive events, irrespective of the filter. CONCLUSION: Longer storage of WB before processing results in counting higher numbers of PLTs in WB, higher numbers of WBCs in WBC-reduced RBCs, and more weak PI-positive events.     

Blood components produced from whole blood using the Atreus processing system

BACKGROUND: The Atreus 2C+ system (Gambro BCT) automates whole blood (WB) processing into a single device. This study compared the quality of red blood cells (RBCs), fresh‐frozen plasma (FFP), and buffy coats (BCs) made from WB held with or without active cooling. STUDY DESIGN AND METHODS: WB was collected into Atreus disposables and stored with (n = 20) or without (n = 20) active cooling for 14 to 18 hours at 22 ± 2°C before processing with the Atreus. Two RBC leukodepletion filters were assessed, and markers of RBC quality were tested to Day 42. BCs were held for 3 hours before testing, plasma was tested, and samples were frozen for coagulation analysis. RESULTS: RBCs met UK specifications for volume, hemoglobin content (48 ± 5 g), and hematocrit (Hct). Hemolysis, adenosine triphosphate, 2,3‐diphosphoglycerate, potassium, glucose, and lactate throughout storage were all within expected ranges. No differences were seen in RBC produced from WB held with or without active cooling. FFP units met UK specification for volume, total protein, cellular contamination, and coagulation factors. No differences were seen in FFP produced from WB held with or without active cooling. The Hct of BCs produced from WB held without active cooling was lower than in BCs from WB held with active cooling; no differences in activation were seen. CONCLUSION: From these in vitro data, blood components produced using the Atreus appear suitable for clinical use, with no clinically significant difference in the quality of components from WB held at ambient temperature overnight with or without active cooling.     

Comparative analysis of platelet concentrates prepared after two hours and overnight storage of buffy coat at room temperature

IntroductionThe overnight storage of the buffy coat (BC) at room temperature has logistic and operational advantages for the blood centre. The present study aimed to evaluate the impact of an overnight hold (stored) of BC at room temperature in comparison with the 2-hour hold (fresh) of buffy coats on the platelet concentrate (PC) characteristics.MethodsA total of 60 BCs were included in the study, 30 PCs (fresh) were prepared after two hours holding time of the BCs and the other 30 PCs (stored) were prepared after the overnight BC storage at room temperature. The primary endpoint of PCs evaluation was the platelet yield, volume, pH, WBC count, RBC count, and platelet swirling in the PC and the secondary endpoints were glucose concentration, lactate, LDH, and sterility of the PCs. All the tests were performed on the day+1 of the blood collection.ResultsThere was no difference concerning the volume, RBC count, and swirling between the two groups (P>0.05). The PCs from the fresh BC had higher pH and glucose concentration (P<0.05). On the other hand, the overnight hold of BC produced higher platelet counts, WBC counts, lactate, and LDH levels (P<0.05). All the 60 PCs did not record any bacterial growth on the culture media for the sterility results.ConclusionThe overnight hold of BC produces a higher platelet yield with higher storage lesions. This may also allow better supervision, ensuring better quality control.     

Transfusion reactions: a comparative observational study of blood components produced before and after implementation of semiautomated production from whole blood

BACKGROUND: A semiautomated method of component production from whole blood was implemented at Canadian Blood Services. To assess safety of the new components, the frequency of adverse transfusion events (ATEs) to platelet components (PCs) and red blood cell (RBCs) produced before and after implementation of the new method was surveyed and compared. STUDY DESIGN AND METHODS: This retrospective, observational, noninferiority study was conducted in 12 sentinel hospitals across Canada. The control group received RBCs in additive solution‐3 (AS‐3) and platelet‐rich plasma (PRP)‐produced platelets (PLTs) for 3 to 11 months before implementation of semiautomated production, and the study group received RBCs in saline‐adenine‐glucose‐mannitol (SAGM) and buffy coat (BC)‐produced PLTs for 3 to 11 months after implementation. ATE definitions at each hospital and standard practice for reporting did not change between control and study periods. Data for analysis were obtained from databases and original report forms. RESULTS: The pooled risk ratio of a reaction to SAGM versus AS‐3 RBCs was 0.77 (95% confidence interval [CI], 0.66‐0.90), suggesting that SAGM products had significantly lower reaction rates than AS‐3 products (p < 0.01). Reported allergic reactions to RBCs decreased from 0.07% (AS‐3) to 0.04% (SAGM). For PLTs, the difference in reaction rates between BC and PRP was not significant (p = 0.37), and the pooled risk ratio of BC versus PRP was 1.14 (95% CI, 0.86‐1.50). CONCLUSION: The change in manufacturing method was associated with lower reaction rates to SAGM RBCs than to AS‐3 RBCs. Pooled BC PLTs were noninferior to random‐donor PRP PLTs with respect to ATEs.     

In vivo viability of stored red blood cells derived from riboflavin plus ultraviolet light-treated whole blood

BACKGROUND: A novel system using ultraviolet (UV) light and riboflavin (Mirasol System, CaridianBCT Biotechnologies) to fragment nucleic acids has been developed to treat whole blood (WB), aiming at the reduction of potential pathogen load and white blood cell inactivation. We evaluated stored red blood cell (RBC) metabolic status and viability, in vitro and in vivo, of riboflavin/UV light–treated WB (IMPROVE study). STUDY DESIGN AND METHODS: The study compared recovery and survival of RBCs obtained from nonleukoreduced WB treated using three different UV light energies (22, 33, or 44 J/mL_RBC). After treatment, WB from 12 subjects was separated into components and tested at the beginning and end of component storage. After 42 days of storage, an aliquot of RBCs was radiolabeled and autologously reinfused into subjects for analysis of 24‐hour recovery and survival of RBCs. RESULTS: Eleven subjects completed the in vivo study. No device‐related adverse events were observed. By Day 42 of storage, a significant change in the concentrations of sodium and potassium was observed. Five subjects had a 24‐hour RBC recovery of 75% or more with no significant differences among the energy groups. RBC t_1/2 was 24 ± 9 days for the combined three groups. Significant correlations between 24‐hour RBC recovery and survival, hemolysis, adenosine triphosphate (ATP), and CO₂ levels were observed. CONCLUSIONS: This study shows that key RBC quality variables, hemolysis, and ATP concentration may be predictive of their 24‐hour recovery and t_1/2 survival. These variables will now be used to assess modifications to the system including storage duration, storage temperature, and appropriate energy dose for treatment.     

In vitro and in vivo evaluation of a whole blood platelet‐sparing leukoreduction filtration system

BACKGROUND: In‐line leukoreduction (LR) filters decrease adverse clinical sequelae caused by residual white blood cells (WBCs). Such filtration, however, can remove platelets (PLTs) needed for production of PLT concentrates (PCs). This study measured in vitro and in vivo efficacy of a new whole blood PLT‐sparing LR filter (WBPSF) system that performs whole blood (WB) LR using a single closed‐system filtration step. The WBPSF provides three final LR products: AS‐5 red blood cells (RBCs), citrate‐phosphate‐dextrose (CPD) PLTs, and CPD plasma. STUDY DESIGN AND METHODS: Volunteers (n = 59) donated WB processed using the WBPSF system. WB filtration time was recorded, and LR WB was processed into AS‐5 LR RBCs, CPD LR PLTs, and LR plasma. Final components were assayed for in vitro indices, and in vivo characteristics for LR AS‐5 RBCs and CPD PLTs were assayed after radiolabeling. RESULTS: WB filtration time averaged 37 minutes. Transfusion products obtained after WBPSF met all in vitro and in vivo Food and Drug Administration (FDA) requirements. Radiolabeling of LR AS‐5 RBCs after WBPSF showed a 24‐hour RBC recovery of 81.3 ± 5.3% after 42 days of storage. In vivo dual ¹¹¹In/⁵¹Cr radiolabeling of PCs manufactured using WBPSF showed a Day 5 recovery ratio of 80 ± 19% versus fresh autologous PLTs and a survival ratio of 81 ± 17% that of fresh autologous PLTs. CONCLUSION: All WBPSF‐derived transfusion products met or exceeded in vitro and in vivo FDA guidelines. This filtration system is suitable for routine blood center or hospital use in the production of LR AS‐5 RBCs, CPD PLTs, and CPD plasma.     

Effect on the quality of blood components after simulated blood transfusions using volumetric infusion pumps

BACKGROUND: It is unknown whether the use of volumetric infusion pumps for the transfusion of red blood cells (RBCs) or platelet (PLT) concentrates (PCs) affects the quality of the blood components. We therefore investigated the in vitro quality of these components after use of infusion pumps. STUDY DESIGN AND METHODS: Ten different volumetric infusion pumps were used to simulate transfusion with RBCs and PCs. To prevent donor‐dependent differences multiple units were pooled and divided into equal portions. The storage time of RBCs was 30 to 35 days (n = 10 experiments), and for PCs, either 2 (n = 5) or 7 days (n = 5). For RBCs an infusion rate of 100 or 300 mL/hr was used, and for PCs, 600 mL/hr. Transfusions without an infusion pump served as a reference. RESULTS: None of the infusion pumps induced an increase of free hemoglobin, annexin A5 binding, or formation of echinocytes in RBCs compared to reference units. In 2‐ and 7‐day‐old PCs no effect was shown on PLT concentration, annexin A5 binding, mean PLT volume, and morphology score compared to the reference. The CD62P expression of 2‐day‐old PCs was significantly lower after transfusion compared to the reference, that is, 11.7 ± 2.1% versus 8.1 ± 1.3% (p < 0.01). CONCLUSION: There was no adverse effect on the in vitro quality of RBCs or PCs after simulated transfusion using volumetric infusion pumps. A decrease in PLT activation was observed, which can probably be explained by capturing of activated or damaged PLTs in the 200‐µm filter present in the infusion system.     

Generation of neutrophil priming activity by cell-containing blood components treated with pathogen reduction technology and stored in platelet additive solutions

BACKGROUND: Storage of cell‐containing blood components such as platelet concentrates (PCs) and red blood cells (RBCs) results in generation of biologically active compounds, many of which may be associated with adverse transfusion events. Priming of the neutrophil oxidase activity is a common characteristic of many of the biologically active compounds found in stored blood. We evaluated the priming activity of pathogen reduction technology (PRT)‐treated PCs stored in plasma or platelet additive solution (PAS) and PRT‐treated RBCs. STUDY DESIGN AND METHODS: PCs were collected with Trima or Amicus equipment and were PRT treated with the Mirasol PRT system or the Intercept Blood System. Some units were gamma irradiated. Products were stored in 100% plasma or 35% plasma plus PAS. RBCs were washed and PRT treated before storage. Samples were removed throughout storage and priming of the oxidase activity was measured. RESULTS: Platelets collected on Trima or Amicus equipment and stored in plasma or PAS demonstrated increasing priming activity during 5 to 7 days of storage. Gamma irradiation, but not PRT treatment with either technology, further enhanced this priming activity. Supernatants of RBCs stored for 42 days induced priming in untreated controls, but not in washed or Mirasol PRT–treated test products. CONCLUSION: Production of oxidase priming activity increased during storage in all blood products. No significant differences were associated with the collection method, storage in PAS, or PRT treatment. The generation of biologically active compounds, which may serve as an etiology for adverse events, appears to be independent of these processes for collection, storage, and pathogen reduction.     

全血室温放置过夜对血浆制品质量的影响

目的探讨全血室温放置过夜制备的24h冰冻血浆(FP24)质量。方法选取12份自愿捐献的400ml新鲜全血放置室温,将每份全血(采集6相似文献   

Bacteria levels in components prepared from deliberately inoculated whole blood held for 8 or 24 hours at 20 to 24 degrees C

BACKGROUND : An increase from 8 to 24 hours in the time that units of whole blood can be held at room temperature after phlebotomy would give blood centers more flexibility in component manufacturing and might allow receipt of many infectious disease test results prior to component preparation. However, the potential for bacterial growth during prolonged holding periods requires further study. STUDY DESIGN AND METHODS : In the Phase I study, 2-unit pools of ABO-identical whole blood were deliberately inoculated on Day 0 with Staphylococcus aureus or Pseudomonas fluorescens. They were then divided in half and stored at 20 to 24 degrees C. Red cells (RBCs) with additive solution, platelet concentrates (PCs), and frozen plasma were prepared after 8 and 24 hours. Bacteria levels in PCs and RBCs were monitored on Day 1; bacteria levels were measured in plasma after thawing. In the Phase II study, the same basic design as in Phase I was used, except that 10 bacterial species were studied, lower inocula were used, and RBCs prepared after a 24-hour room-temperature whole-blood hold were white cell-reduced by filtration. Bacterial growth was monitored during 42- day storage of RBCs (1 – 6 degrees C) and 5-day storage of PCs (20 – 24 degrees C) and after thawing of frozen plasma. RESULTS : For Phase I, significantly higher bacteria levels were observed in RBCs prepared after a prolonged hold (p < 0.05); higher levels were not observed in PCs and thawed plasma units. In Phase II, prior to white cell reduction by filtration, 8 of 10 organisms had significantly higher levels in RBCs prepared after a 24-hour hold than in RBCs prepared after an 8- hour hold, when both were examined on Day 1 (p < 0.05). For seven of eight organisms examined on Days 1, 21, and 42, filtration (white cell reduction) reduced the bacteria in RBCs prepared from 24-hour whole blood units to those levels found in unfiltered RBCs prepared from whole blood units held at 8 hours. A prolongation of the holding time from 8 to 24 hours resulted in significantly lower bacteria levels (p < 0.05) in PCs early in storage (Days 1, 1 – 2, or 1 – 3) for seven organisms, with no significant difference for two organisms, and a small but significant increase for one organism (Day 3, p < 0.05). There was no difference in bacteria or endotoxin levels in thawed units of plasma prepared from whole blood after 8- or 24-hour holding times. CONCLUSION : The levels of bacteria present in components after deliberately inoculated whole blood units are held for 8 and 24 hours depended on the organisms tested, the whole-blood holding period, and the blood component assayed; for RBCs, they also depended on whether WBC reduction by filtration was performed.     

Evaluation of a whole-blood WBC-reduction filter that saves platelets: in vitro studies

BACKGROUND: In this study, a new WBC-reduction in-line filter that removes WBCs but not platelets was evaluated. Three WBC-reduced blood components were prepared: RBCs, plasma, and platelet concentrates (PCs). STUDY DESIGN AND METHODS: Whole-blood components (n = 30) were filtered within 2 to 4 hours after collection and then were centrifuged and separated into RBCs, plasma, and WBC-reduced buffy coat. Saline-adenine-glucose-mannitol solution was added to the RBCS: The WBC-reduced buffy coats were stored overnight; on the following day, PCs were prepared from pooled WBC-reduced buffy coats and stored in a medium composed of approximately 35 percent CPD plasma and 65 percent platelet additive solution (T-Sol, Baxter). The WBC-reduction capacity of the filter, the recovery of cells after filtration, and the in vitro storage of RBCs (n = 10) and platelets (n = 6) were evaluated. RESULTS: Mean and maximum WBC counts after filtration were 0.08 x 10(6) and 0.3 x 10(6), respectively, per filtered whole-blood unit. Recovery of RBCs (mean values) after filtration was 90 percent in whole-blood components and 73 percent in RBCS: Recovery of platelets (mean values) was 81 percent after filtration and 66 percent in PCS: The in vitro storage study of RBCs showed results comparable with previously published data, except for a lower degree of hemolysis. In the in vitro platelet storage study, results were compared with those of standard preparations. In all essentials, similar results were found. CONCLUSION: The results of the present study suggest that effective WBC reduction meets current standards and satisfactory recovery after filtration. The storage characteristics for RBCs and PCs are similar to those of standard preparations. Use of a whole-blood in-line filter to save platelets is a new option for whole-blood processing, which may simplify WBC reduction and blood component preparation, as well as reduce costs in the future.     

Plasma and cryoprecipitate manufactured from whole blood held overnight at room temperature meet quality standards

BACKGROUND: With buffy coat (BC) processing of whole blood (WB) donations, the preparation of plasma occurs within 24 hours rather than 8 hours of collection. The effect of this change on coagulation factor function in plasma and cryoprecipitate was evaluated during the validation of this production method and with routine production. STUDY DESIGN AND METHODS: Plasma frozen after an overnight hold of WB was prepared via BC or whole blood filtration (WBF) methods and quality control (QC) variables were measured. Additionally, plasma prepared with the BC method was compared to plasma produced using the platelet‐rich plasma (PRP) method with an extended plasma factor analysis. Selected plasma factor levels were also measured in both cryoprecipitate and cryosupernatant plasma prepared using the WBF method from plasma frozen on the day of collection or after an overnight hold of WB. RESULTS: When comparing BC plasma to PRP plasma, coagulation factors (F)II, VII, VIII, IX, X, and XI had somewhat lower levels, and fibrinogen and antithrombin levels were elevated. As expected the most sensitive to the prolongation of production time was FVIII with 72 and 78% of the activity of PRP plasma and cryoprecipitate, respectively. However, both still met QC standards. Similarly, products made in routine production show acceptable levels of FVIII. CONCLUSION: Plasma and cryoprecipitate products, prepared using methods in which the plasma is frozen close to 24 hours after collection, meet current quality standards. The longer WB storage time has been implemented into general use in Canada.     

Survival of Borrelia burgdorferi in blood products

The incidence of Lyme disease is rapidly increasing in the United States. To assess the potential of transmission of the disease through blood transfusion, we studied the survival of Borrelia burgdorferi in blood products under blood bank storage conditions. Two units of whole blood, separated into red cells (RBCs), fresh-frozen plasma (FFP), and platelet concentrates (PCs), were inoculated with B. burgdorferi (strain B31) in concentrations of approximately 3000 organisms per mL of RBCs and FFP and 200 organisms per mL of PCs. Products were then stored under blood banking conditions and sampled at several storage times. The viability of the spirochete in blood components was determined by darkfield microscopic examination of cultures in modified Kelly's medium. The organism was shown to survive in RBCs (4 degrees C) and FFP (below -18 degrees C) for 45 days and in PCs (20-24 degrees C) for 6 days. The results of this study do not exclude the possibility of transmission of Lyme disease through blood transfusion.     

Evaluation of a new whole-blood filter that allows preparation of platelet concentrates by platelet-rich plasma methods

BACKGROUND: A novel WBC-reduction in-line whole-blood (WB) filter that does not retain platelets was evaluated to assess the filtration performance and, after processing WB by the platelet-rich plasma (PRP) method, to analyze the storage quality of filtered platelet concentrate (PC) units. STUDY DESIGN AND METHODS: To analyze the filter retention, blood was collected from random donors into quadruple blood packs with an integral in-line filter (Imuflex WB-SP, Terumo; n = 25) or in standard triple bag systems (n = 30). To assess the in vitro storage characteristics of platelets, 26 WB units were pooled in pairs and redistributed into 13 units that underwent WBC reduction and 13 units that were not WBC reduced. In all cases, WB was separated into RBCs, PCs, and plasma by the PRP method and platelet function was compared. RESULTS: The filtration procedure led to RBC and PC WBC-reduced products that met the AABB and European requirements. The average filtration time was 30 minutes, the filter retained about 45 mL of WB, and there was no further loss of RBCs during the fractionation procedure. In vitro PC storage characteristics of the filtered units were similar to those of the nonfiltered units. CONCLUSION: A 4- and 3-log WBC reduction was observed in RBC and PC units that were produced by the PRP method, with a mean residual WBC content of 0.24 +/- 0.38 x 106 and 0.02 +/- 0.03 x 106 per unit, respectively. The procedure, performed under relatively simple logistics, results in good-quality, standard components that may reduce costs and ease the process of WBC reduction in transfusion services.     

In vitro characteristics of red blood cell concentrates prepared from under- and overcollected units of whole blood and from a paediatric blood bag system

The problem of how to deal with red blood cell concentrates (RBCs) prepared from under- or overcollected units of whole blood (WB) and how to collect blood from underweight persons arises in the context of autologous predeposit. To determine the quality of RBCs stored in PAGGS-M additive solution prepared from under- and overcollected units of whole blood and of PAGGS-M RBCs prepared from a paediatric 250-mL top outlet blood bag system we measured blood picture, haemolysis, K+, pH, ATP and 2,3-DPG on days 0, 10, 20, 30, 40 and 49 of storage. The volume of WB collected ranged from 150 to 600 mL in 50-mL increments (4 units per volume). Haemolysis was under 0.8% on day 49 in all RBCs prepared from WB donations between 200 mL and 600 mL. However, the day 49 haemolysis level of standard RBCs prepared from 450 mL of WB (0.15 +/- 0.03%) was reached earlier in RBCs from under- and overcollected units of whole blood. 2,3-DPG levels decreased rapidly between days 10 and 20 in all RBCs studied. RBCs from 450-mL donations showed acceptable ATP maintenance after 49 days (70.4% of day 0 value), while all other RBC ATP levels were below 50% of the day 0 level on day 49. In vitro quality data of RBCs prepared from a 250-mL donation in the paediatric blood bag system after storage for about 25 days were comparable to those after 49 days of storage of standard RBCs. Our results suggest that it is feasible to transfuse PAGGS-M RBCs prepared from under- as well as overcollected units of WB in the autologous setting. However, we strongly recommend shortening the storage period of such RBCs to maintain the quality level of standard RBCs.