Red blood cell hemolysis during blood bank storage: using national quality management data to answer basic scientific questions. 2009

John R Hess, and Rosemary L Sparrow, and Pieter F van der Meer, and Jason P Acker, and Rebecca A Cardigan, and Dana V Devine
Department of Pathology, University of Maryland, Baltimore, Maryland 21201, USA. jhess@umm.edu

BACKGROUND Hemolysis of red blood cells (RBCs) during blood bank storage is the most obvious manifestation of RBC storage system failure. However, its analysis is made difficult because the largest source of interunit difference is donor specific. Availability of data from national blood systems on large numbers of RBC units used for internal quality control (QC) purposes and stored and processed in uniform ways permits statistical analysis. METHODS Measures of hemolysis during and at the end of storage on randomly selected donor units observed for QC purposes were obtained from four national blood systems. Groups of these measures from units that had undergone similar processing and storage were sorted to create histograms and the histograms were compared statistically. RESULTS A total of 14,087 measures were obtained under seven storage conditions, including more than 12,000 measures made in a single country under four closely related conditions. Distributions of percent hemolysis are skewed normal and outliers are random. Additive solutions appear to be equivalent, except that the 42 mmol/L mannitol in AS-1 reduces hemolysis compared to conventional 30 mmol/L mannitol in saline, adenine, glucose, and mannitol. Increasing storage from 35 to 42 days increased measured hemolysis by 30% and leukoreduction decreased it by 53%. CONCLUSIONS Large national data sets provide useful information about the distribution of hemolysis at the end of RBC storage. This information can aid blood storage system development and regulatory science.

UI MeSH Term Description Entries
D009313 National Health Programs Components of a national health care system which administer specific services, e.g., national health insurance. National Health Insurance, Non-U.S.,Health Services, National,National Health Insurance,National Health Insurance, Non U.S.,National Health Services,Services, National Health,Health Insurance, National,Health Program, National,Health Programs, National,Health Service, National,Insurance, National Health,National Health Program,National Health Service,Program, National Health,Programs, National Health,Service, National Health
D011786 Quality Control A system for verifying and maintaining a desired level of quality in a product or process by careful planning, use of proper equipment, continued inspection, and corrective action as required. (Random House Unabridged Dictionary, 2d ed) Control, Quality,Controls, Quality,Quality Controls
D001771 Blood Banks Centers for collecting, characterizing and storing blood or plasma. Bank, Blood,Banks, Blood,Blood Bank
D001793 Blood Preservation The process by which blood or its components are kept viable outside of the organism from which they are derived (i.e., kept from decay by means of a chemical agent, cooling, or a fluid substitute that mimics the natural state within the organism). Blood Preservations,Preservation, Blood,Preservations, Blood
D006461 Hemolysis The destruction of ERYTHROCYTES by many different causal agents such as antibodies, bacteria, chemicals, temperature, and changes in tonicity. Haemolysis,Extravascular Hemolysis,Intravascular Hemolysis,Extravascular Hemolyses,Haemolyses,Hemolyses, Extravascular,Hemolyses, Intravascular,Hemolysis, Extravascular,Hemolysis, Intravascular,Intravascular Hemolyses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016208 Databases, Factual Extensive collections, reputedly complete, of facts and data garnered from material of a specialized subject area and made available for analysis and application. The collection can be automated by various contemporary methods for retrieval. The concept should be differentiated from DATABASES, BIBLIOGRAPHIC which is restricted to collections of bibliographic references. Databanks, Factual,Data Banks, Factual,Data Bases, Factual,Data Bank, Factual,Data Base, Factual,Databank, Factual,Database, Factual,Factual Data Bank,Factual Data Banks,Factual Data Base,Factual Data Bases,Factual Databank,Factual Databanks,Factual Database,Factual Databases
D017707 Erythrocyte Transfusion The transfer of erythrocytes from a donor to a recipient or reinfusion to the donor. Red Blood Cell Transfusion,Red Blood Cell Transfusions,Transfusion, Red Blood Cell,Transfusions, Red Blood Cell,Erythrocyte Transfusions,Transfusion, Erythrocyte,Transfusions, Erythrocyte
D047589 Leukocyte Reduction Procedures The removal of LEUKOCYTES from BLOOD to reduce BLOOD TRANSFUSION reactions and lower the chance of transmitting VIRUSES. This may be performed by FILTRATION or by CYTAPHERESIS. Leukocyte Depletion Procedures,Leukocyte Reduction Filtration,Leukocyte Removal Procedures,Depletion Procedure, Leukocyte,Depletion Procedures, Leukocyte,Filtration, Leukocyte Reduction,Filtrations, Leukocyte Reduction,Leukocyte Depletion Procedure,Leukocyte Reduction Filtrations,Leukocyte Reduction Procedure,Leukocyte Removal Procedure,Procedure, Leukocyte Depletion,Procedure, Leukocyte Reduction,Procedure, Leukocyte Removal,Procedures, Leukocyte Depletion,Procedures, Leukocyte Reduction,Procedures, Leukocyte Removal,Reduction Filtration, Leukocyte,Reduction Filtrations, Leukocyte,Reduction Procedure, Leukocyte,Reduction Procedures, Leukocyte,Removal Procedure, Leukocyte,Removal Procedures, Leukocyte
D038622 Internationality The quality or state of relating to or affecting two or more nations. (After Merriam-Webster Collegiate Dictionary, 10th ed) Globalization,International Aspects,International Perspectives,International Relations,Multinational Aspects,Multinational Perspectives,Aspect, International,Aspect, Multinational,Aspects, International,Aspects, Multinational,International Aspect,International Perspective,Multinational Aspect,Multinational Perspective,Perspective, International,Perspective, Multinational,Perspectives, International,Perspectives, Multinational,Relations, International

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