Background - To guarantee the quality of red blood cell (RBC) transfusion, RBC concentrates (RCCs) are stored at 4±2°C. Deviations to this specification can alter the RBCs. Although the exposure to higher temperatures is well documented, the exposition to subzero temperatures has been less investigated.
Materials and methods - RCCs (prepared from top-bottom kits and stored in saline-adenine-glucose-mannitol - SAGM) accidentally exposed to temperatures below 0°C were investigated in two regional blood services in Switzerland; Case 1: 1 h 52 min below 0°C (minimum of −5.7°C), and Case 2: 3 h 19 min below 0°C (minimum of −0.9°C). In case 1, 5 exposed and 5 unexposed RCCs were visually inspected for hemolysis or other alterations. Hemolysis was quantified in the 5 exposed RCCs and one control. In Case 2, 71 RCCs were analyzed at the time of the incident and at day 42 for hematological parameters and hemolysis. Ten RCCs were followed weekly for glucose, lactate, potassium levels and deformability.
Results - Under these conditions no signs of out-of-specification hemolysis or RBC damages were observed. Nevertheless, a higher hemolysis was reported in 4-day-old RCCs exposed to subzero temperature compared to existing and age-matched controls. Storage lesions were equivalent to unexposed RCCs and to literature.
Discussion - The two present real cases of RCCs exposure to temperatures below 0°C did not show damage to RBCs over storage. Even though the present work did not investigate the limits of RBCs sensitivity to cold temperature, it provides indications on the capability of RCCs to resist such type of storage deviation.
Stefano Fontana
- Fondazione Servizio Trasfusionale CRS della Svizzera Italiana, Lugano, Switzerland; Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
Michel Prudent
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland; Center for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
, Mauro Borri
, Agathe Martin
, David Crettaz
, Jeremy Touati
, Simon Hänni
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