Irradiation Of Blood Components Research Articles

Characteristics of red cells irradiated and subsequently frozen for long-term storage.

Irradiation of blood components eliminates the risk of transfusion-associated graft-versus-host disease. Freezing directed or rare red cell units that are irradiated but not transfused would facilitate inventory management and would increase the transfusion options for the involved patients. However, no studies have been performed to evaluate whether prestorage irradiation damages subsequently frozen red cells. Ten normal volunteers donated a unit of whole blood on two separate occasions. One unit was irradiated with 15 Gy (1500 rad), stored at 4 degrees C for 6 days, and then frozen and stored at -75 degrees C for 56 days. The other unit (control) was similarly stored but was not irradiated. Aliquots of the units were tested on Day 0 and Day 6 and, after deglycerolization, on Day 62. Comparison of means and changes in means showed no significant differences in red cell ATP, 2,3 DPG, or supernatant hemoglobin and glucose in control and irradiated units. The difference in the change in supernatant potassium from Day 0 to Day 6 in control and irradiated units was significant (1.5 to 28.6 mmol/L vs. 1.5 to 48.5 mmol/L: p < 0.0001). Irradiation did not cause significant differences in postdeglycerolization red cell recovery (control, 84.5% vs. irradiated, 81.2%) or in 24-hour posttransfusion autologous red cell survival (control, 91.1% vs. irradiated, 90.9%). Red cells can be irradiated, stored at 4 degrees C for 6 days, and subsequently frozen with no increase in detectable damage as compared to controls that were not irradiated.

The effect of prestorage irradiation on posttransfusion red cell survival.

Transfusion-associated graft-versus-host disease (TA-GVHD) may occur whenever immunologically competent allogeneic lymphocytes are transfused to an immunocompromised recipient. Irradiation of blood components eliminates the risk of TA-GVHD but may damage the cellular elements in the transfused component, particularly if the cells are stored for prolonged periods in the irradiated state. To study the effect of irradiation on long-term storage of red cells, AS-1 red cells from eight normal subjects were prepared on two occasions. On one occasion, the units were stored as standard AS-1 red cells for 42 days at 4 degrees C; on the other, they were exposed to 3000 cGy radiation within 4 hours of collection and then were stored as AS-1 red cells for 42 days at 4 degrees C. The donations were at least 12 weeks apart. Irradiated units demonstrated significant elevations in poststorage plasma hemoglobin (Hb) (623 +/- 206 vs. 429 +/- 194 g/dL [6230 +/- 2060 vs. 4290 +/- 1940 g/L], p less than 0.02) and plasma potassium (78 +/- 4 vs. 43 +/- 9 mEq/L [78 +/- 4 vs. 43 +/- 9 mmol/L], p less than 0.01) and significant decreases in red cell ATP (1.9 +/- 0.2 vs. 2.1 +/- 0.3 microM/g Hb, p less than 0.04) and 24-hour posttransfusion red cell recovery (68.5 vs. 78.4%, p less than 0.02), as compared to nonirradiated units. It can be concluded that irradiation with 3000 cGy damages red cells and that long-term storage in the irradiated state may enhance this damage. Red cells should not be stored for 42 days after irradiation with 3000 cGy.

Variation in blood component irradiation practice: implications for prevention of transfusion-associated graft-versus-host disease

RAFT-VERSUS-HOST DISEASE (GVHD) is comG monly observed after allogeneic bone marrow transplantation (BMT), but transfusion-associated (TA) GVHD is only rarely reported. Although early reports of TAGVHD were recognized in immunocompromised hosts, more recent cases have been documented in immunocompetent transfusion recipients. The increasing awareness of this serious complication of transfusion prompted a national survey of transfusion medicine practices to identify patients at risk for TA-GVHD and assess methods for its prevention. HISTORICAL PERSPECTIVE The reported cases of TA-GVHD have recently been summarized.' To date, it has been documented after transfusion of unirradiated blood components to at least 87 patients: in patients with severe combined immunodeficiency, thymic hypoplasia, and Wiskott Aldrich syndrome2.'*; premature newborns and those with erythroblastosis fetali~'~-*~; patients with hematologic malignancies including Hodgkin's and non-Hodgkin's lymphomas, acute myelocytic and lymphoblastic leukemias, chronic lymphocytic leukemia, and aplastic patients with solid tumors including neuroblastomas, glioblastoma, rhabdomyosarcoma, cervical carcinoma, small cell lung cancer, and germ cell tum08'-'~; patients after cardiac surgery and cholecystectomp-60; and in an apparently healthy 22-year-old woman.6' This syndrome has developed after neonatal exchange and intrauterine transfusions; and after transfusion of whole blood, fresh (nonfrozen) plasma, red blood cells, and platelets. Leukocytes harvested from normal donors and from donors with chronic myelocytic leukemia transfused to patients with hematologic malignancies have also been implicated in TA-GVHD. TA-GVHD results in an overall mortality of 84% at a median of 21 (8 to 1,050) days after transfusion.'

Variation in Blood Component Irradiation Practice: Implications for Prevention of Transfusion-Associated Graft-Versus-Host Disease

Variation in Blood Component Irradiation Practice: Implications for Prevention of Transfusion-Associated Graft-Versus-Host Disease

The effects of irradiation on platelet function.

Current medical practice involves the irradiation of blood components, including platelet concentrates, before their administration to patients with severe immunosuppression. The authors studied the effect of irradiation on in vitro platelet function and the leaching of plasticizers from the bag, both immediately and after 5 days of storage. The platelet count, white cell count, pH, glucose, lactate, platelet aggregation and release reaction, and serotonin uptake were not altered by the irradiation of random-donor or apheresis units with 2000 rads carried out at 0 and 24 hours and 5 days after collection. The leaching of di(2-ethylhexyl)phthalate from the plastic bags followed by the conversion to mono(2-ethylhexyl)phthalate was not increased by irradiation. Therefore, it is possible to irradiate platelet concentrates on the day of collection and subsequently store them for at least 5 days while maintaining in vitro function. This procedure could have considerable benefit for blood banks involved in the provision of many platelet products.

Superoxide generation and cytotactic response of irradiated neutrophils.

Irradiation of blood components has been used to prevent transfusion-related graft-versus-host disease (GVHD) in immunocompromised patients. This study was designed to determine the effect of irradiation on neutrophil aggregation, chemotaxis, and superoxide generation. Purified neutrophils were irradiated with a Cesium source at four doses ranging from 0 to 17,500 rads. Formyl-methionyl-leucyl-phenylalanine (FMLP) and zymosan-treated serum (ZTS) cytotaxin-induced chemotaxis and migration were determined in the agarose assay. Neutrophil aggregation to FMLP was determined by aggregometry. Superoxide generation and random migration were not affected by irradiation at doses up to 17,500 rads. When compared to nonirradiated controls, the chemotactic response to ZTS remained normal, with an insignificant decline from 174 +/- 31.0 to 150 +/- 42.3 (mean +/- SD) units. The chemotactic response to FMLP declined insignificantly, from 228 +/- 31.3 at 0 rad to 207 +/- 26.4 at 17,500 rads. The aggregation response to FMLP remained within the normal range but declined from 0.78 +/- 0.11 to 0.61 +/- 0.18. At the radiation doses currently used to reduce the risk of transfusion-related GVHD, neutrophil superoxide generation and chemotactic response remain essentially normal.