Red cells can be modified during the manufacturing process to help meet the clinical needs of certain patients. Red cells can be frozen, washed and collected from IgA deficient blood donors.
Frozen red cells
Red cells can be frozen for up to 30 years or sometimes longer if there is a particular need for specific units of rare red cells. Glycerol is added to red cells as a cryoprotective agent and then frozen at or below -65°C.
Prior to transfusion, the glycerol must be removed from the thawed component by washing the red cells with sodium chloride. After washing, the red cells are resuspended in additive solution and must be transfused within 24 hours. There is a significant loss of red cells during the freezing and thawing process, and this process takes several hours to complete.
When should I use this modification?
For patients with rare red cell phenotypes or who have multiple red cell antibodies, or for autologous collections where liquid-preserved blood can’t meet the patient’s needs.
Washed red cells
Red cells are washed to remove the majority of unwanted plasma proteins including antibodies..
Some red cells are lost during this process.
When should I use this modification?
The following groups of patients should receive washed components:
- Patients who have experienced reactions to transfused plasma proteins e.g. those with IgA deficiency with an anti-IgA antibody.
- Patients with severe recurrent allergic or febrile reactions of unknown cause.
IgA-deficient components
Red cells can be washed to provide an lgA-deficient product.
lgA-deficient platelet and plasma components are sourced from lgA-deficient donors with an lgA level <0.001 g/L.
When should I use this modification?
IgA-deficient platelets and plasma are indicated for IgA-deficient patients with known anti-IgA antibodies who experience recurrent severe allergic or anaphylactic reactions.
IgA-deficient red cells are indicated for IgA-deficient patients with known anti-IgA antibodies who experience allergic reactions with washed red cells.
Updated April 2025
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