Prestorage white cell reduction in saline‐adenine‐glucose‐mannitol red cells by use of an integral filter: evaluation of storage values and invivo recovery

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Abstract
BACKGROUND: Prestorage white cell (WBC) reduction in blood components may decrease the incidence of adverse reactions and improve component quality. A bottom‐and‐top system with an integral third‐generation WBC‐ reduction filter has been studied. STUDY DESIGN AND METHODS: Whole blood was collected from 30 healthy donors: from 20 by using a blood container system with an integral filter and from 10 controls by using a standard blood container system. Ten test units were buffy coat‐ depleted, stored for 72 hours at 4 degrees C, and then filtered, while an additional 10 test units were buffy coat‐depleted and filtered at room temperature within 8 hours of collection. All units were stored at 4 degrees C for 42 days and sampled weekly. RESULTS: The mean WBC content of the 72‐hour, 4 degrees C units was 0.33 × 10(6), that of the room‐temperature units was 2.6 × 10(6), and that of the buffy coat‐ depleted controls was 460 × 10(6) (p < 0.0005). No significant differences were found among lactate, glucose, sodium, potassium, and plasma hemoglobin levels in the three groups. ATP and 2,3 DPG levels were significantly better preserved in control units than in 72‐hour, 4 degrees C units (p = 0.016 and p = 0.032, respectively), but not better than in the room‐temperature units. Significant differences were observed between pH values in filtered units and both groups of test units (p = 0.016). In biologic terms however, these differences were small. Red cells from an additional eight healthy volunteer donors were processed by an 8‐hour room‐temperature method and stored for 35 days. Studies in vivo 24‐hour recovery of autologous red cells were performed by transfusing a radiolabeled (51Cr plus 131I‐albumin) aliquot after 35 days' storage. Good recovery (mean > 80%) was found by both the single‐ and double‐isotope‐label methods. Recovery was significantly greater when calculated by the single‐isotope method (p = 0.02). CONCLUSION: The combination of buffy coat removal and filtration in the blood container system with an integral filter achieved effective WBC reduction (> or = 3 log10 reduction from whole blood) without biologically significant detriment to in vitro or in vivo storage values.