Practical concerns with the irradiation of Red Cells either before or after they have been frozen (and thawed)

A manager at a blood center in a Pacific Coast state reports that his facility freezes donor RBC units that have been irradiated. However, he is concerned that there might be special circumstances that would cause frozen irradiated red cells to be too fragile for the deglycerolization process. He wonders what the practice is at other facilities in regard to to freezing previously irradiated red cells, and what other facilities are concerned about (if anything) when they do this.

The following comments have been received.

ADDENDA Jan. 17, 2005

1. A physician affiliated with a multi-state donor collection network reports that there is no prohibition to freezing irradiated RBCs, nor is there a specific requirement that irradiated RBCs be treated differently from any other RBC unit that is to be frozen. However, such a product might be unlicensed. Various products that can be (or have been) frozen and irradiated include the following:
   • Red Blood Cells Frozen Irradiated
   • Red Blood Cells Frozen Rejuvenated Irradiated
   • Red Blood Cells Deglycerolized Irradiated
   • Red Blood Cells Rejuvenated Deglycerolized Irradiated
   • Red Blood Cells Leukocyte-Reduced Irradiated Frozen
     
     
2. An administrator affiliated with another multi-state donor collection network comments that for a frozen irradiated component to be licensed a center needs to be licensed for freezing, deglycerolizing, as well as irradiation of the components. He also comments that the directions in the manufacturer's insert (provided by the component container manufacturer) should be followed. He adds that even though rejuvenating red cells is an acceptable practice, his network does not do it; nor do they have SOPs for this. This means that they do not make Red Blood Cells Frozen Rejuvenated Irradiated or Red Blood Cells Rejuvenated Deglycerolized Irradiated. They have no prohibition against freezing a unit of Red Blood Cells Leukocyte Reduced that has been irradiated, or against irradiating a unit of Red Blood Cells Deglycerolized.

ADDENDA Jan. 18, 2005

3. A colleague in the Pennsylvania/New Jersey area suggests that the publication by Suda BA et al of the NIH in Transfusion (May 1993) entitled "Characteristics of red cells irradiated and subsequently frozen for long-term storage" might be germane to this discussion. Although the rise in supernatant potassium levels in deglyc'd units that had been irradiated before freezing was higher than in non-irradiated units no other significant changes were observed.
   
   
4. The Director of Blood Component Management at a donor collection center in California reports that her facility will freeze irradiated RBC units only if there is an exceptional reason to do so, and only if their medical director gives approval. They will irradiate deglycerolized RBC units without special approval. She reports that they have not seen a problem with the aforementioned approach.

ADDENDA Jan. 24, 2005

5. A colleague at New York Blood Center reports that they do not freeze irradiated RBCs, but they do irradiate RBCs that have been frozen and deglycerolized.

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