Majed A Refaai1, Grace W Conley1, Kelly F Henrichs1, Hannah McRae1, Amy E Schmidt1, Richard P Phipps1,2,3,4, Sherry L Spinelli1, Debra Masel1, Jill M Cholette3, Anthony Pietropaoli4, Michael P Eaton5, Neil Blumberg1. 1. Department of Pathology and Laboratory Medicine, Transfusion Medicine Division, Rochester, NY. 2. Departments of Environmental Medicine and Microbiology and Immunology, Rochester, NY. 3. Department of Pediatrics and Critical Care and Cardiology Division, Golisano Children's Hospital, Rochester, NY. 4. Department of Medicine, Pulmonary and Critical Care Division, Rochester, NY. 5. Department of Anesthesia, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY.
Abstract
OBJECTIVES: Washing cellular blood products is accepted to ameliorate repeated severe allergic reactions but is associated with RBC hemolysis and suboptimal platelet function. We compared in vitro hemolysis and platelet function in blood components after washing with Plasma-Lyte A (PL-A) vs normal saline (NS). METHODS: RBC (n = 14) were washed/resuspended in NS or PL-A. Free hemoglobin and heme were determined at 0, 24, 48, and 72 hours. Platelet concentrates (PCs; n = 21) were washed with NS or PL-A and resuspended in same washing solution (n = 13) or ABO-identical plasma (n = 8). Platelet aggregation and spreading were evaluated. RESULTS: The 24-hour free hemoglobin and heme levels were higher in NS (P < .05). Improved platelet function was observed in PL-A-washed PCs (P < .001). DISCUSSION: PL-A showed less RBC hemolysis and better platelet function than NS. Whether such differences would occur in vivo is unknown.
OBJECTIVES: Washing cellular blood products is accepted to ameliorate repeated severe allergic reactions but is associated with RBC hemolysis and suboptimal platelet function. We compared in vitro hemolysis and platelet function in blood components after washing with Plasma-Lyte A (PL-A) vs normal saline (NS). METHODS: RBC (n = 14) were washed/resuspended in NS or PL-A. Free hemoglobin and heme were determined at 0, 24, 48, and 72 hours. Platelet concentrates (PCs; n = 21) were washed with NS or PL-A and resuspended in same washing solution (n = 13) or ABO-identical plasma (n = 8). Platelet aggregation and spreading were evaluated. RESULTS: The 24-hour free hemoglobin and heme levels were higher in NS (P < .05). Improved platelet function was observed in PL-A-washed PCs (P < .001). DISCUSSION: PL-A showed less RBC hemolysis and better platelet function than NS. Whether such differences would occur in vivo is unknown.
Authors: Jill M Cholette; Hannah L McRae; Ron Angona; Christine Cahill; Michael F Swartz; George M Alfieris; Majed A Refaai Journal: J Extra Corpor Technol Date: 2021-09
Authors: Ian J Welsby; Philip J Norris; William J Mauermann; Mihai V Podgoreanu; Chelsea M Conn; Laurie Meade; Tamara Cannon; Sheila M Keating; Christopher C Silliman; Marguerite Kehler; Phillip J Schulte; Daryl J Kor Journal: Anesthesiology Date: 2021-03-01 Impact factor: 7.892