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AGGREGATE FORMATION DURING STORAGE OF RED CELLS CONCENTRATE-LEUKOCYTE REDUCED, "NISSEKI"

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  • 赤血球濃厚液-LR「日赤」の保存中に形成される凝集塊について

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Abstract

A number of studies have shown the formation of various sizes of aggregates during storage of red cells concentrate (RC-MAP) supplied by the Japanese Red Cross until 2007. Among aggregates, macroaggregates are known to cause the clogging of transfusion filters at the bed side, and microaggregates are suggested to induce transfusion-related pulmonary embolism. Since the introduction of a prestorage leukocyte reduction system containing a CPD solution instead of an ACD-A solution as anticoagulant, and the supply of Red Cells Concentrate-Leukocyte Reduced (RCC-LR) in the blood program in Japan, the formation of macroaggregates and microaggregates has not been reported. We evaluated the formation of macroaggregates and microaggregates during storage of RCC-LR containing CPD solution. In addition, since the criteria for the use of a microaggregate screen filter have not been determined, we measured the number of microaggregates in RCC-LR before and after use of a microaggregate screen filter. Our results showed that no macroaggregates were formed in the storage of RCC-LR, and that the number of microaggregates in RCC-LR was significantly lower than that in RC-MAP. No significant change in the number of microaggregates was observed between pre- and post-filtered RCC-LR using a microaggregate screen filter. From our results, it is expected that transfusion of RCC-LR without using a microaggregate screen filter in adult patients with chronic anemia and related conditions may not cause adverse effects due to microaggregates, although the possibility cannot be ruled out that a small amount of microaggregates in RCC-LR still may be harmful in patients during massive transfusion or pediatric transfusion.<br>

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