Leukoreduction filtration of whole-blood units from sickle trait donors: Effects of a metered citrate anticoagulant system

Barbara Bryant, Maria Bianchi, Robert A. Wesley, David F. Stroncek, Susan F. Leitman

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

BACKGROUND: Polymerization of hemoglobin (Hb) S is exacerbated by acidic and hyperosmotic citrate anticoagulant solutions and often results in occlusion of leukoreduction filters by red blood cells (RBCs) from sickle cell trait (Hb AS) donors. This study evaluates a blood collection instrument that adds citrate anticoagulant in a metered fashion, thus mitigating adverse citrate effects. STUDY DESIGN AND METHODS: Collection of whole blood by a metered anticoagulant system was compared to traditional phlebotomy in 12 Hb AS and 12 non-sickle trait (Hb AA) donors. Each donated twice; on one occasion, units were filtered after 4-hour storage at 20 to 24°C, and on the other, units were stored at 1 to 6°C for 24 hours before filtration. RESULTS: Filtration times, RBC recoveries, and residual white blood cell (WBC) counts met defined criteria more often in Hb AS units collected by a metered anticoagulant system (9 of 12, 8 of 12, and 4 of 12, respectively) compared to traditional phlebotomy (1 of 12, 2 of 12, and 0 of 12, respectively). Overall, Hb AS units filtered better after storage at 1 to 6°C for 24 hours, with units collected by a metered anticoagulant system undergoing filtration most effectively (5 of 6 had >85% RBC recovery, 3 of 6 had 6 residual WBC). Units exhibited similar changes in RBC storage parameters. CONCLUSION: Use of a metered anticoagulation instrument demonstrates potential for successful leukoreduction and acceptable storage of Hb AS units; however, the system needs further modifications and improvements before it can be utilized to collect and leukoreduce Hb AS blood.

Original languageEnglish (US)
Pages (from-to)2233-2241
Number of pages9
JournalTransfusion
Volume47
Issue number12
DOIs
StatePublished - Dec 2007
Externally publishedYes

Fingerprint

Citric Acid
Anticoagulants
Erythrocytes
Phlebotomy
Sickle Cell Trait
Sickle Hemoglobin
Leukocyte Count
Polymerization
hemoglobin AS
Leukocytes

ASJC Scopus subject areas

  • Hematology
  • Immunology

Cite this

Leukoreduction filtration of whole-blood units from sickle trait donors : Effects of a metered citrate anticoagulant system. / Bryant, Barbara; Bianchi, Maria; Wesley, Robert A.; Stroncek, David F.; Leitman, Susan F.

In: Transfusion, Vol. 47, No. 12, 12.2007, p. 2233-2241.

Research output: Contribution to journalArticle

Bryant, Barbara ; Bianchi, Maria ; Wesley, Robert A. ; Stroncek, David F. ; Leitman, Susan F. / Leukoreduction filtration of whole-blood units from sickle trait donors : Effects of a metered citrate anticoagulant system. In: Transfusion. 2007 ; Vol. 47, No. 12. pp. 2233-2241.
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abstract = "BACKGROUND: Polymerization of hemoglobin (Hb) S is exacerbated by acidic and hyperosmotic citrate anticoagulant solutions and often results in occlusion of leukoreduction filters by red blood cells (RBCs) from sickle cell trait (Hb AS) donors. This study evaluates a blood collection instrument that adds citrate anticoagulant in a metered fashion, thus mitigating adverse citrate effects. STUDY DESIGN AND METHODS: Collection of whole blood by a metered anticoagulant system was compared to traditional phlebotomy in 12 Hb AS and 12 non-sickle trait (Hb AA) donors. Each donated twice; on one occasion, units were filtered after 4-hour storage at 20 to 24°C, and on the other, units were stored at 1 to 6°C for 24 hours before filtration. RESULTS: Filtration times, RBC recoveries, and residual white blood cell (WBC) counts met defined criteria more often in Hb AS units collected by a metered anticoagulant system (9 of 12, 8 of 12, and 4 of 12, respectively) compared to traditional phlebotomy (1 of 12, 2 of 12, and 0 of 12, respectively). Overall, Hb AS units filtered better after storage at 1 to 6°C for 24 hours, with units collected by a metered anticoagulant system undergoing filtration most effectively (5 of 6 had >85{\%} RBC recovery, 3 of 6 had 6 residual WBC). Units exhibited similar changes in RBC storage parameters. CONCLUSION: Use of a metered anticoagulation instrument demonstrates potential for successful leukoreduction and acceptable storage of Hb AS units; however, the system needs further modifications and improvements before it can be utilized to collect and leukoreduce Hb AS blood.",
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N2 - BACKGROUND: Polymerization of hemoglobin (Hb) S is exacerbated by acidic and hyperosmotic citrate anticoagulant solutions and often results in occlusion of leukoreduction filters by red blood cells (RBCs) from sickle cell trait (Hb AS) donors. This study evaluates a blood collection instrument that adds citrate anticoagulant in a metered fashion, thus mitigating adverse citrate effects. STUDY DESIGN AND METHODS: Collection of whole blood by a metered anticoagulant system was compared to traditional phlebotomy in 12 Hb AS and 12 non-sickle trait (Hb AA) donors. Each donated twice; on one occasion, units were filtered after 4-hour storage at 20 to 24°C, and on the other, units were stored at 1 to 6°C for 24 hours before filtration. RESULTS: Filtration times, RBC recoveries, and residual white blood cell (WBC) counts met defined criteria more often in Hb AS units collected by a metered anticoagulant system (9 of 12, 8 of 12, and 4 of 12, respectively) compared to traditional phlebotomy (1 of 12, 2 of 12, and 0 of 12, respectively). Overall, Hb AS units filtered better after storage at 1 to 6°C for 24 hours, with units collected by a metered anticoagulant system undergoing filtration most effectively (5 of 6 had >85% RBC recovery, 3 of 6 had 6 residual WBC). Units exhibited similar changes in RBC storage parameters. CONCLUSION: Use of a metered anticoagulation instrument demonstrates potential for successful leukoreduction and acceptable storage of Hb AS units; however, the system needs further modifications and improvements before it can be utilized to collect and leukoreduce Hb AS blood.

AB - BACKGROUND: Polymerization of hemoglobin (Hb) S is exacerbated by acidic and hyperosmotic citrate anticoagulant solutions and often results in occlusion of leukoreduction filters by red blood cells (RBCs) from sickle cell trait (Hb AS) donors. This study evaluates a blood collection instrument that adds citrate anticoagulant in a metered fashion, thus mitigating adverse citrate effects. STUDY DESIGN AND METHODS: Collection of whole blood by a metered anticoagulant system was compared to traditional phlebotomy in 12 Hb AS and 12 non-sickle trait (Hb AA) donors. Each donated twice; on one occasion, units were filtered after 4-hour storage at 20 to 24°C, and on the other, units were stored at 1 to 6°C for 24 hours before filtration. RESULTS: Filtration times, RBC recoveries, and residual white blood cell (WBC) counts met defined criteria more often in Hb AS units collected by a metered anticoagulant system (9 of 12, 8 of 12, and 4 of 12, respectively) compared to traditional phlebotomy (1 of 12, 2 of 12, and 0 of 12, respectively). Overall, Hb AS units filtered better after storage at 1 to 6°C for 24 hours, with units collected by a metered anticoagulant system undergoing filtration most effectively (5 of 6 had >85% RBC recovery, 3 of 6 had 6 residual WBC). Units exhibited similar changes in RBC storage parameters. CONCLUSION: Use of a metered anticoagulation instrument demonstrates potential for successful leukoreduction and acceptable storage of Hb AS units; however, the system needs further modifications and improvements before it can be utilized to collect and leukoreduce Hb AS blood.

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