Abstract
Background The high prevalence of haemoglobin variants and glucose 6-phosphate dehydrogenase disorder (G6PDd) in sub-Saharan Africa means that substantial proportions of donor blood units carry these red cell abnormalities. Aim This study investigated the impact that inherited haemoglobin variants and/or G6PD status have on whole blood banked at 4–6°C for 35 days. Method This repeated-measure cohort study was undertaken on 103 donor blood units collected into blood bag containing CPDA-1 anticoagulant. On days 0, 7, 14, 21, and 35, full blood count, osmotic-induced haemolysis, and plasma K+ levels were estimated. Also, on day 0, G6PD status, haemoglobin variants, % foetal haemoglobin, and blood group of donor units were determined using methaemoglobin reductase, cellulose acetate electrophoresis, modified Bekte alkali denaturation assay, and slide haemagglutination test, respectively. Result Overall, although plasma K+ levels increased during storage, donor units from individuals ≥20 years, G6PD normal, Hb AC, or blood group B had comparatively higher percentage change in plasma K+ during storage. Osmotically induced haemolysis of donor units was significantly decreased in Hb AC (compared with Hb A or AS) donor units on days 7, 14, 21, and 35 (p < 0.0001 in each case). G6PDd donor units had comparatively reduced osmotic-induced lysis compared with G6PD normal units, reaching a statistical significance on day 35 (p = 0.043). Also, Hb AC units had comparatively nonstatistically higher plasma K+ at all time points (compared with Hb A or AS). Furthermore, whereas donor units from individuals ≥20 years showed significantly higher median free haemoglobin on day 21 (compared to donor <20 years), when donor units were stratified per Hb variants, only Hb AS units had median free haemoglobin below the 0.8% threshold after 35 days' storage. Conclusion Age of donor, blood group, Hb AC variant, and G6PD status may be important considerations in the storability of whole blood.
Highlights
In sub-Saharan Africa, blood transfusions are usually in response to anaemia caused by malaria, haemoglobinopathies, and road-traffic accidents
It is generally recognized that blood units collected from different donors but banked in the same anticoagulant and stored for the same number of days may show differing levels of storage lesion [14,15]. is is indicative that inherent donor characteristics influence the degree of blood donor storage lesion
We sought to explore the potential impact of inherited glucose 6-phosphate dehydrogenase deficiency (G6PD) status, haemoglobin variants, blood group, and donor age on some parameters of storage lesion of whole blood units banked at 4°C in CPDA-1 for 35 days
Summary
In sub-Saharan Africa, blood transfusions are usually in response to anaemia caused by malaria, haemoglobinopathies, and road-traffic accidents. 19.5–25.5% of blood donors have been estimated to be carrying qualitative glucose 6-phosphate dehydrogenase deficiency (G6PD) disorder in the subregion [4, 5]. In spite of the estimated high prevalence of inheritance of sickle cell trait and G6PD deficiency among blood donors in the subregion, there is paucity of data on how these inherited donor characteristics influence red cell storage lesion as most of the previous studies were cross-sectional studies. Using % free haemoglobin, osmotic-induced red cell lysis, and plasma potassium as a measure of whole blood storage lesion, we sought to determine the effect of blood donors’ G6PD status, haemoglobin type, age, percentage foetal haemoglobin, and blood group on whole blood units stored in citrate phosphate dextrose 1 (CPDA-1) for 35 days (at 2°C–6°C)
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