Assessment Of Storage Related Hematological And Biochemical Changes Of Citrate Phosphate Dextrose Adenine-1 Whole Blood.

Abstract

INTRODUCTION Blood transfusion is life saving, being administered to approximately 5 million patients per year in India. Blood can be stored under refrigeration in preservative solutions such as citrate phosphate dextrose adenine (CPDA- 1) solution for up to 35 days. These storage solutions have met the requirements mandating that red blood cells (RBCs) transfused at the end of the approved storage period should have at least 75% of the cells remaining in the circulation 24 hours after infusion, and that the hemolysis in the stored bag be <1%. Upon storage, RBCs undergo numerous biochemical and physiological changes with the concomitant release of potentially hazardous bioactive products referred to as RBC storage lesions. OBJECTIVE A cross-sectional study was carried out on 50 blood donors who donated blood voluntarily in the blood bank of Shri B.M.Patil Medical College, Hospital and Research Centre from December 2014 to June 2016.This study was done to determine certain hematological & biochemical changes in blood when stored during different periods of time (at 5 storage periods from zero to 28 days) using CPDA-1solution as preservative. MATERIALS & METHODS: Prospective blood donors who fulfilled standard blood donor selection were included in the study. The study was carried out on donors who come to donate blood voluntarily in our blood bank. After blood donation of 350/450 ml of whole blood, a blood sample consisted of 15 ml from each blood bag was taken. Each sample was divided into 5 portions, each portion consists of 3 ml of blood was added into plain test tube. One of these tubes was analyzed on the day of collection, which is regardedas control. The other tubes are kept in blood bank refrigerator at 4-60 C to be analyzed on day 7, day 14, day 21, day 28. Each sample was analyzed using the 5 part differentiated automated Hematoanalyzer for hematological parameters like RBC count, WBC count, Platelet count, Hemoglobin, Hematocrit (PCV), Mean cellular hemoglobin (MCH) and Cobas C 311 biochemical analyzer to measure Plasma Potassium. RESULT Analysis of variance (ANOVA) showed that at the end of 28 days, there was significant decrease in WBC count (P<0.01), Platelet count (P<0.01) among hematological parameters and plasma potassium levels (P<0.01) was significantly increased compared on day 0 to day 28. No significant changes were observed in other parameters throughout the study. CONCLUSION The present study indicates that rapid degeneration of WBCs could lead to immunomodulation. Therefore, Whole blood or RBC concentrates should be leukodepleted before storage. Blood banks should also check for baseline K level on the day of collection and blood bags should be selected for transfusion by harmonising low K with the first in first output (FIFO) system. Potassium absorption filters should be used during transfusion to prevent transfusion related hyperkalemia.