Higher donor body mass index is associated with increased hemolysis of red blood cells at 42‐days of storage: A retrospective analysis of routine quality control data

• Published in: Transfusion (Philadelphia, Pa.) Vol. 61; no. 2; pp. 449 - 463
• Main Authors: Sparrow, Rosemary L., Payne, Katherine A., Adams, Geoffrey G.
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.02.2021; Wiley Subscription Services, Inc
• Subjects: Age; Body mass; Body mass index; Body size; Body weight; Buffy coat; Confidence intervals; Control data (computers); donor‐related factors; Erythrocytes; Hemoglobin; Hemolysis; Males; Obesity; Overweight; quality; Quality control; red blood cells; Regression analysis; Regression models; Sex; Statistical analysis; Variables; red blood cells; body mass index; donor-related factors; hemolysis; sex; quality
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1111/trf.16203

Background For reasons unclear, some stored red blood cells (RBCs) have low hemolysis, while others have high hemolysis, which impacts quality consistency. To identify variables that influence hemolysis, routine quality control (QC) data for 42‐days‐stored RBCs with corresponding donor information were analyzed. Study Design and Methods RBC QC and donor data were obtained from a national blood supplier. Regression models and analyses were performed on total cohort stratified by donor sex and by high hemolysis (≥90th percentile) vs control (<90th percentile) samples, including matching. Results Data included 1734 leukoreduced RBCs (822 female, 912 male), processed by buffy coat–poor or whole blood filtration methods. Male RBCs had larger volume, hemoglobin content, and higher hemolysis than female RBCs (median hemolysis, 0.24% vs 0.21%; all P < .0001). Multivariable regression identified increased body mass index (BMI) and RBC variables were associated with higher hemolysis (P < .0001), along with older female age and buffy coat–poor processing method (P < .002). Logistic regression models comparing the high and control hemolysis subsets, matched for RBC component variables and processing method, identified overweight‐obese BMI (>27 kg/m2) in males remained the single donor‐related variable associated with higher hemolysis (P < .0001); odds ratio, 3 (95% confidence interval [CI], 1.3‐6.7), increasing to 4 (95% CI, 1.8‐8.6) for obese males (BMI > 30 kg/m2). Female donor obesity and older age trended toward higher hemolysis. Conclusion Donor BMI, sex, and female age influence the level of hemolysis of 42‐days‐stored RBCs. Other factors, not identified in this study, also influence the level of hemolysis. See editorial on page 336–339, in this issue