Clinical and Quality Evaluation of Red Blood Cell Units Collected Via Apheresis Versus Those Obtained Manually

Eiman Hussein, MD; Azza Enein, MD


Lab Med. 2014;45(3):238-243. 

In This Article

Abstract and Introduction


To evaluate the impact of collection procedure on the in vitro quality of red blood cells (RBC), we studied 30 units of apheresis-prepared RBC (ARBC) and 30 units of manually collected RBC (MRBC). We performed assays on day 1 and day 21 of the study, evaluating red cell mass volume (RCM); rate of hemolysis; pH, and levels of sodium, potassium, adenosine triphosphate (ATP), 2,3-diphosphoglycerate (2,3-DPG) and glucose. Eight patients with aplastic anemia received RBC transfusions of both components and their post-transfusion hematocrit (HCT) levels were compared. On day 21, we observed a significant drop of sodium and glucose levels in the ARBC group, compared with the MRBC group (P <.05). ARBC group demonstrated higher RCM that provided significantly higher HCT values to our group of anemic patients (P <.05). Hemolysis was significantly lower in the ARBC group, compared with the MRBC group (P <.05). At day 21, both groups had no detectable 2,3-DPG. Specimens from both groups retained ATP in sufficiently healthy amounts. The ARBC group demonstrated higher RCM and lower hemolysis levels compared with the MRBC group.


New transfusion technology allows selective collection of different components via apheresis. This process involves collecting combinations of blood components, including red blood cells (RBC), from a single donation, which can reduce donor exposure and transmission of infectious diseases. Most RBC units used for transfusion are prepared from anticoagulated whole blood. Automated collection of RBC via apheresis can potentially provide a standardized, high-quality product with consistent RBC content.[1]

Hemolysis is an important parameter for measuring the quality of RBC. Hemolysis is caused by disruption of the RBC membrane and the subsequent release of hemoglobin (Hb). Hemolysis of RBC can occur during preparation and during storage. The extent of hemolysis is often defined as the percentage of free hemoglobin in relation to the hematocrit (HCT). According to the United States Food and Drug Administration (FDA) guidelines, hemolysis in stored RBC units should not exceed 1%. Recently, the FDA has added that 95% of units should meet quality standards and that the data for these units must show statistical certainty.

To evaluate the impact of the collection procedure on the quality of packed RBC, we studied apheresis-prepared RBC (ARBC) prepared via the Gambro Trima Accel device (Gambro BCT, Lakewood, Colorado, USA) and manually collected RBC (MRBC) stored in bags containing citrate-phosphate-dextrose adenine (CPDA-1) anticoagulant. Another objective of our study was to investigate the impact of collection procedure on the viability of RBC after transfusion by measuring post-transfusion HCT levels.