Biochemical changes in irradiated Red Blood Cells stored up to 42 days

Abstract

Introduction: Irradiation of whole blood and cellular components is currently the only effective method of preventing the severe complication of transfusion-associated graft-versus-host disease (TA-GvHD). The main indication for irradiated blood and blood components is for patients with congenital or acquired immunological deficiency, in cases of neonatal intrauterine and exchange transfusions as well as in close relationship between donor and recipient. Irradiation of blood and blood components results in the inactivation of T lymphocytes, more sensitive to irradiation than other therapeutically active cells such as erythrocytes, platelet concentrates and granulocytes. No optimal dose of gamma irradiation for Red Blood Cell Concentrates (RBCs) and Platelet Concentrates (PCs) has yet been determined. The aim of this study was to determine the effect of two different irradiation doses (25 Gy, 50 Gy) on the in vitro functions of RBCs as well as changes in irradiated RBCs stored in ADSOL for various periods of time (7 , 14, 28, 35, 42 days of storage at 4°C).
Material and methods: The study involved 45 units of RBCs in ADSOL. The following tests were performed to assess the quality of in vitro functions of RBCs: erythrocyte (RBC) and leukocyte (WBC) counts, hematocrit (Ht), supernatant hemoglobin (Hb), potassium( K⁺) and sodium concentration (Na⁺), adenosine-tri-phosphate concentration (ATP), 2,3-diphosphoglycerate (2,3-DPG) and pH.
Results: The statistically significant increase of K⁺ was determined in irradiated PCs (50 Gy) on all storage days. The same level of 2,3-DPG concentration was found in control group and RBCs irradiated with 25 Gy, while the 2,3-DPG concentration in groups irradiated with 50 Gy was only 0,04 mmol/ml.
Conclusion: Comparison of the basic biochemical parameters (APT level, 2,3-DPG, Hb, K⁺ concentration) of the 25 and 50 Gy irradiated RBCs with those of the unirradiated RBCs, gives grounds for conclusion that RBCs irradiated with 50 Gy should not be stored at 4°C for more than 14 days, whether in ADSOL or not, while RBCs irradiated with 25 Gy can be stored up to 28 days prior to transfusion. In vitro tests demonstrate that irradiated RBCs function well in the recipient’s circulatory system.