Search

Background: Therapeutic phlebotomy is the preferred treatment for iron overload associated with hemochromatosis. In the Netherlands, red blood cell concentrates (RCCs) from hemochromatosis patients are not used for transfusion purposes. In this study, their storage performance was compared with that of control donors as a first step in the evaluation of their potential usefulness for transfusion., Study Design and Methods: RCCs were obtained from hemochromatosis patients and regular donors, either by apheresis or by whole-blood collection, and stored up to 50 days under routine Dutch blood bank conditions. Weekly samples were taken for determination of hematologic, biophysical, and biochemical variables., Results: Most variables displayed the same storage-related changes in RCCs originating from hemochromatosis patients as in those from regular donors. In all RCCs, hemolysis remained well below the guideline limit of 0.8 percent for up to 6 weeks of storage, and the glucose concentration remained above the required 5 mmol per L up to 5 weeks of storage. After 4 weeks of storage, the mean ATP level remained above the required limit of 75 percent of the starting value in all RCCs as well. The major difference was a larger mean cell volume in hereditary hemochromatosis RBCs up to 50 days of storage., Conclusions: RCCs from hemochromatosis patients comply with the in vitro quality requirements for transfusion. This paves the way for the final step, namely, the establishment of the 24-hour RBC posttransfusion recovery.

During the last 90 years many developments have taken place in the world of blood transfusion. Several anticoagulants and storage solutions have been developed. Also the blood processing has undergone many changes. At the moment, in The Netherlands, red blood cell (RBC) concentrates (prepared from a whole blood donation and leukocyte-depleted by filtration) are stored for a maximum of 35 days at 4 degrees C in saline adenine glucose mannitol (SAGM). Most relevant studies show that approximately 20% of the RBCs is lost in the first 24 hr after transfusion. Even more remarkable is that the average life span is 94 days after a storage period of 42-49 days. Such observations create the need for a parameter to measure the biological age of RBCs as a possible predictor of the fate of RBCs after transfusion. The binding of IgG to RBCs can lead to recognition and subsequent phagocytosis by macrophages. This occurs during the final stages of the RBC life span in vivo. We determined the quantity of cell-bound IgG during storage, and found considerable variation between RBCs, but no significant storage-related change in the quantity of cell-bound IgG. The significance of this finding for predicting the survival of transfused RBCs in vivo remains to be established. Hereto we developed a flow cytometric determination with a sensitivity of 0.1% for the measurement of survival in vivo based on antigenic differences. This technique has various advantages compared with the 'classical' 51Cr survival method.