REMOVAL OF ABO-INCOMPATIBLE RED-CELLS FROM LYMPHOCYTAPHERESIS AND GRANULOCYTAPHERESIS COMPONENTS BEFORE TRANSFUSION

BACKGROUND: The collection of allogeneic lymphocytapheresis and granul ocytapheresis components containing significant volumes of ABO-incompa tible red cells is sometimes necessary. STUDY DESIGN AND METHODS: Twen ty-nine ABO-incompatible lymphocytapheresis components collected for t ransfusion to three patients and 11 ABO-incompatible granulocytapheres is components collected for transfusion to five patients were depleted of red cells by gravity sedimentation aided by the addition of hetast arch solution. The efficacy of red cell depletion and white cell reten tion and the complications of transfusion were analyzed. RESULTS: Lymp hocytapheresis components contained 82 +/- 13 percent of the original white cells and 5 +/- 3 mL of red cells after depletion; however, for those components containing <70 mL of red cells before depletion (n = 12), white cell recovery was 92 +/- 5 percent. After depletion, granul ocytapheresis components contained 96 +/- 3 percent of the original wh ite cells and 6 +/- 2 mL of red cells. No clinical or laboratory evide nce of hemolysis was observed after the transfusion of any leukapheres is component. CONCLUSION: Red cells can be effectively removed from le ukacytapheresis components by a simple gravity sedimentation technique with added hetastarch. This allows safe transfusion of ABO-incompatib le components.