Visual assessment of hemolysis in red blood cell units and segments can be deceptive

Kim A. Janatpour, T. G. Paglieroni, V. L. Crocker, D. J. DuBois, P. V. Holland

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

BACKGROUND: Blood components that appear hemolyzed are discarded. However, visual inspection is subjective and criteria for excessive hemolysis are poorly defined. STUDY DESIGN AND METHODS: Packed RBCs (10 CPDA-1, 10 Adsol) were collected. Half of each unit was leukoreduced. Plasma Hb was measured and compared in segments and units by three methods: 1) a HemoCue Plasma/Low Hb Photometer system; 2) a tetramethylbenzidine (TMB) chemical method, and 3) a free Hb visual comparator. RESULTS: Visual assessment tended to overestimate hemolysis. Chemical methods were comparable (r2 = 0.894; HemoCue = 0.043 + [0.770] × TMB; n = 400; range, 0.01-0.5 g/dL), although the mean plasma Hb (g/dL) for the HemoCue method was higher than that of the TMB method (0.12 vs. 0.10 g/dL, respectively; p < 0.001). No units would have been discarded based on a hemolysis level of at least 0.6 g/dL (approx. 1%) if measured by a chemical method. However, 50 percent of CPDA-1 and 10 percent of Adsol units would have been discarded if only visual criteria were used. Leukoreduction did not increase plasma Hb levels. Discrepancies in plasma Hb levels were noted between units and their corresponding segments. CONCLUSION: Visual assessment of hemolysis can result in unnecessary wastage of blood components. HemoCue offers an alternative, objective method to assess plasma Hb in the setting of blood collection and processing facilities for routine quality control and process validation, and may aid in the development of objective criteria for excessive hemolysis in blood components.

Original languageEnglish (US)
Pages (from-to)984-989
Number of pages6
JournalTransfusion
Volume44
Issue number7
DOIs
StatePublished - Jul 2004

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Hemolysis
Erythrocytes
Quality Control

ASJC Scopus subject areas

  • Hematology
  • Immunology

Cite this

Janatpour, K. A., Paglieroni, T. G., Crocker, V. L., DuBois, D. J., & Holland, P. V. (2004). Visual assessment of hemolysis in red blood cell units and segments can be deceptive. Transfusion, 44(7), 984-989. https://doi.org/10.1111/j.1537-2995.2004.03315.x

Visual assessment of hemolysis in red blood cell units and segments can be deceptive. / Janatpour, Kim A.; Paglieroni, T. G.; Crocker, V. L.; DuBois, D. J.; Holland, P. V.

In: Transfusion, Vol. 44, No. 7, 07.2004, p. 984-989.

Research output: Contribution to journalArticle

Janatpour, KA, Paglieroni, TG, Crocker, VL, DuBois, DJ & Holland, PV 2004, 'Visual assessment of hemolysis in red blood cell units and segments can be deceptive', Transfusion, vol. 44, no. 7, pp. 984-989. https://doi.org/10.1111/j.1537-2995.2004.03315.x
Janatpour, Kim A. ; Paglieroni, T. G. ; Crocker, V. L. ; DuBois, D. J. ; Holland, P. V. / Visual assessment of hemolysis in red blood cell units and segments can be deceptive. In: Transfusion. 2004 ; Vol. 44, No. 7. pp. 984-989.
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abstract = "BACKGROUND: Blood components that appear hemolyzed are discarded. However, visual inspection is subjective and criteria for excessive hemolysis are poorly defined. STUDY DESIGN AND METHODS: Packed RBCs (10 CPDA-1, 10 Adsol) were collected. Half of each unit was leukoreduced. Plasma Hb was measured and compared in segments and units by three methods: 1) a HemoCue Plasma/Low Hb Photometer system; 2) a tetramethylbenzidine (TMB) chemical method, and 3) a free Hb visual comparator. RESULTS: Visual assessment tended to overestimate hemolysis. Chemical methods were comparable (r2 = 0.894; HemoCue = 0.043 + [0.770] × TMB; n = 400; range, 0.01-0.5 g/dL), although the mean plasma Hb (g/dL) for the HemoCue method was higher than that of the TMB method (0.12 vs. 0.10 g/dL, respectively; p < 0.001). No units would have been discarded based on a hemolysis level of at least 0.6 g/dL (approx. 1{\%}) if measured by a chemical method. However, 50 percent of CPDA-1 and 10 percent of Adsol units would have been discarded if only visual criteria were used. Leukoreduction did not increase plasma Hb levels. Discrepancies in plasma Hb levels were noted between units and their corresponding segments. CONCLUSION: Visual assessment of hemolysis can result in unnecessary wastage of blood components. HemoCue offers an alternative, objective method to assess plasma Hb in the setting of blood collection and processing facilities for routine quality control and process validation, and may aid in the development of objective criteria for excessive hemolysis in blood components.",
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AU - Holland, P. V.

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AB - BACKGROUND: Blood components that appear hemolyzed are discarded. However, visual inspection is subjective and criteria for excessive hemolysis are poorly defined. STUDY DESIGN AND METHODS: Packed RBCs (10 CPDA-1, 10 Adsol) were collected. Half of each unit was leukoreduced. Plasma Hb was measured and compared in segments and units by three methods: 1) a HemoCue Plasma/Low Hb Photometer system; 2) a tetramethylbenzidine (TMB) chemical method, and 3) a free Hb visual comparator. RESULTS: Visual assessment tended to overestimate hemolysis. Chemical methods were comparable (r2 = 0.894; HemoCue = 0.043 + [0.770] × TMB; n = 400; range, 0.01-0.5 g/dL), although the mean plasma Hb (g/dL) for the HemoCue method was higher than that of the TMB method (0.12 vs. 0.10 g/dL, respectively; p < 0.001). No units would have been discarded based on a hemolysis level of at least 0.6 g/dL (approx. 1%) if measured by a chemical method. However, 50 percent of CPDA-1 and 10 percent of Adsol units would have been discarded if only visual criteria were used. Leukoreduction did not increase plasma Hb levels. Discrepancies in plasma Hb levels were noted between units and their corresponding segments. CONCLUSION: Visual assessment of hemolysis can result in unnecessary wastage of blood components. HemoCue offers an alternative, objective method to assess plasma Hb in the setting of blood collection and processing facilities for routine quality control and process validation, and may aid in the development of objective criteria for excessive hemolysis in blood components.

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