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

Transfusion
K A JanatpourP V Holland

Abstract

Blood components that appear hemolyzed are discarded. However, visual inspection is subjective and criteria for excessive hemolysis are poorly defined. 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 tetramethyl-benzidine (TMB) chemical method, and 3) a free Hb visual comparator. Visual assessment tended to overestimate hemolysis. Chemical methods were comparable (r(2)= 0.894; HemoCue = 0.043 +[0.770]x 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. Visual assessment of hemolysis can result in unnecessary wastage of blood components. HemoCue offers ...Continue Reading

References

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Citations

Jul 5, 2013·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·M SugimotoK Muroi
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Nov 4, 2020·Journal of Veterinary Emergency and Critical Care·Jessica M WeeksMiryam M Reems

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