Evaluating the quality of X‐ray irradiated deglycerolized red blood cells stored in saline‐adenosine‐glucose‐mannitol additive solution

Abstract Background Rare phenotype red blood cells (RBCs) are routinely cryopreserved and stored at −80°C for over 10 years. Upon thawing and deglycerolization, RBCs resuspended in saline‐adenosine‐glucose‐mannitol (SAGM) have a limited 24‐h shelf‐life. There is a lack of international consensus as to whether irradiation of deglycerolized RBCs is necessary for patients at risk of transfusion‐associated graft‐versus‐host disease. The aim of this study was to evaluate the quality of X‐ray irradiated deglycerolized RBCs resuspended in SAGM. Study design and methods Matched RBC components ( n = 21 pairs) were glycerolized with 40% glycerol, frozen at −80°C, deglycerolized using an ACP‐215 cell washer, and resuspended in SAGM. One of each pair was X‐ray irradiated post‐deglycerolization, while the other remained untreated (control). RBCs were sampled pre‐freeze and immediately, 24‐, 48‐, and 72‐h post‐irradiation. Quality indicators including RBC indices, metabolic, and biochemical parameters were measured. Results There were no significant differences between X‐irradiated and control groups for volume, hemoglobin (Hb), hematocrit, or supernatant Hb immediately post‐thaw. Hemolysis was higher in X‐irradiated deglycerolized RBCs (0.35 ± 0.14%) than controls (0.32 ± 0.05%) after 24‐h ( p = 0.077). Potassium (K + ) release was significantly higher in X‐irradiated RBCs compared to controls after 24‐h (6.26 ± 0.95 mmol/unit vs. 3.21 ± 1.01 mmol/unit respectively; p < .001). Discussion X‐irradiation had a significant effect on K + release from deglycerolized RBCs during storage, and to a lesser extent, hemolysis. The K + and hemolysis levels at 24 h post‐irradiation were acceptable, as were the other quality parameters, indicating that X‐irradiation of these components is feasible.