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  • Title: Understanding the effects of gamma-irradiation on potassium levels in red cell concentrates stored in SAG-M for neonatal red cell transfusion.
    Author: Winter KM, Johnson L, Kwok M, Reid S, Alarimi Z, Wong JK, Dennington PM, Marks DC.
    Journal: Vox Sang; 2015 Feb; 108(2):141-50. PubMed ID: 25195496.
    Abstract:
    BACKGROUND AND OBJECTIVES: Red cell transfusions, to paediatric patients, are often gamma-irradiated to prevent transfusion-associated graft-versus-host disease. This study measured changes in potassium and other in vitro parameters immediately following gamma-irradiation of paediatric and full-size red cell concentrates (RCCs). MATERIALS AND METHODS: The effects of irradiation on potassium release in RCCs stored in SAG-M were investigated under three scenarios. In the first scenario, RCC < 5 days was split into paediatric packs, gamma-irradiated and tested for potassium and haemolysis at 0, 2, 4, 6, 24 and 48 h. In the second scenario, full-size RCCs < 5 days postcollection were gamma-irradiated and tested as for the paediatric packs. Thirdly, RCCs < 14 days postcollection were gamma-irradiated and assessed at 6 and 24 h and 7 and 14 days. Each group contained paired controls that were not gamma-irradiated. RESULTS: In all situations, gamma-irradiation resulted in a twofold increase in potassium concentrations after 24 h of storage, compared to matched unirradiated controls. This difference was detectable as early as 2 h postirradiation. Few differences were observed between control and irradiated RCCs in other key parameters, including ATP, 2,3-DPG, haemoglobin, pH, glucose and lactate concentration. CONCLUSION: Gamma-irradiation of RCCs significantly increased extracellular potassium. Irradiation of fresher RCCs results in lower potassium concentrations, which is less likely to lead to hyperkalaemia upon transfusion.
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