Department of Transfusion Medicine and Haemostaseology, University Hospital Erlangen, Erlangen, Germany.
Vox Sang. 2011 Jul;101(1):21-7. doi: 10.1111/j.1423-0410.2010.01455.x. Epub 2010 Dec 14.
The effect of gamma irradiation on leucoreduced red-blood-cells (RBCs) stored in an additive solution (AS) containing phosphate, adenine, glucose, guanosine, saline and mannitol (PAGGS-M) has not yet been studied, and there are different recommendations about storage time of leucoreduced RBCs after irradiation.
We studied 63 leucoreduced RBC units. All RBCs were stored in AS PAGGS-M and leucoreduced on the collection day. Twenty-one components were irradiated on Day +14 with 30 Gy and 22 served as non-irradiated controls. Samples were drawn and analysed from these 43 units on Day +7, +14, +21, +28, +35, +42 and +49 from the collection day. From 20 units, no samples were taken earlier than on Day +49. Of these, 10 components had been irradiated on Day +14 with 30 Gy and 10 served as non-irradiated controls.
Gamma irradiation induced an enhanced in vitro haemolysis rate in the irradiated components. One of the irradiated units showed a haemolysis rate over the recommended limit of 0·8% on Day +42 and four on Day +49. The leakage of potassium ions from irradiated RBCs started to increase faster than that of unirradiated RBCs from the day of irradiation. Lactate dehydrogenase levels increased faster in irradiated units 3 weeks after irradiation. We showed that taking samples weekly does not affect the final result.
Our findings show that the European recommendations should not be changed in regard to the limitation of the storageability after irradiation of leucoreduced RBCs. The damage after irradiation and storage cannot be prevented by using the high-quality AS PAGGS-M.
目前尚未研究经过添加了磷酸盐、腺嘌呤、葡萄糖、鸟嘌呤、生理盐水和甘露醇的添加剂溶液(PAGGS-M)保存的去白细胞红细胞(RBC)在γ射线照射下的效果,而且对于去白细胞 RBC 照射后储存时间也有不同的建议。
我们研究了 63 个去白细胞 RBC 单位。所有 RBC 均在 AS PAGGS-M 中储存,并在采集日进行去白细胞处理。21 个单位在第 14 天照射 30 Gy,22 个单位作为非照射对照。从采集日起,这些 43 个单位的样本分别在第 7、14、21、28、35、42 和 49 天抽取和分析。从 20 个单位中,有部分单位的样本采集时间早于第 49 天。其中,10 个单位在第 14 天照射 30 Gy,10 个单位作为非照射对照。
γ射线照射会导致照射单位的体外溶血率增加。其中一个照射单位在第 42 天的溶血率超过了 0.8%的推荐限制,四个单位在第 49 天超过。从照射日开始,照射 RBC 中的钾离子漏出速度比未照射 RBC 更快。照射 3 周后,照射单位中的乳酸脱氢酶水平上升速度更快。我们表明,每周取样不会影响最终结果。
我们的研究结果表明,不应改变欧洲关于去白细胞 RBC 照射后储存时间限制的建议。使用高质量的 PAGGS-M 添加剂溶液并不能防止照射和储存造成的损伤。