الفهرس | Only 14 pages are availabe for public view |
Abstract During storage, RBCs undergo various metabolic, structural and morphological changes, the so-called storage lesions. The acceptable extent of the metabolic changes forms a major part of the blood bank quality guidelines. PRBCs are widely used for the treatment of patients with anemia of different etiologies. For this purpose it is important that the transfused RBCs preserve their metabolic capacity and mechanical functions. It is therefore very important to control the quality of PRBC units. The method by which blood products are produced, the storage solution used, and other factors as prestorage leukoreduction have an effect on the final product and may influence quality. Product standardization is thus a challenge facing all blood biologic manufacturers The current study was carried out on 20 PRBC units at 4 testing time points (D1, 10, 20 and 35) to evaluate the effect of storage on PRBCs. We measured various biochemical parameters ( Plasma Na+, K+, ATP , 2,3 DPG and blood gases) and other hematological parameters (WBCs, Hb, Hct, % hemolysis, RBC indices and abnormal cells %) in rder to assess the quality of these units according to the regulatory standards.the results of this study demonstrated that with increasing the period of storage, there was statistically significant increase in plasma K+ concentration, decrease in plama Na+ concentration, ATP and 2,3 DPG. Also, there was statistically significant increase in PCO2 level, decrease in PO2 level and O2 saturation. Regarding the hematological parameters measured there was a statistical significant decrease in WBCs, increase in % hemolysis, MCV and abnormal cells %. On performing a correlation study, there was a moderate significant correlation between the increase in % hemolysis and the % decrease in WBC count at the end of storage (at D35) and this is due to the degeneration of WBCs and releasing of various chemicals and enzymes, especially proteases from the leukocytes. Also, there was a moderate correlation between increase % hemolysis and % decrease of ATP denoting the effect of ATP depletion on Loss of membrane deformability and viability. Upon applying the WHO and FDA quality control standards to our PRBC units across storage time, all of the units were within the acceptable quality control standards except for one unit (5%) was below the WHO guideline level as regards Hb content. Also 4 units (20%) were below the WHO guideline level for Hct level. Finally, 2 units (10%) exceeded the FDA.guideline level for % hemolysis at D1 and they increased to 3 units (15%) at D35. Finally, our study demonstrates that the storage lesion (biochemical and hematological changes) is a condition which will always occurs with the prolonged storage time. Some measures could be taken to slow down this process to improve the quality of the PRBC units at different storage times. It is our duty to properly apply the quality control measures from the beginning of the process, starting from selection of donors, processing (anticoagulant, additive solution and blood bag material used) and storage conditions (refrigerator temperature) in order to be able to determine the good and sufficient units which will benefit the patients. |