A review of correlation between transfusion rate of irradiated blood and potassium load
Miyao, H.; Shimizu, K.; Kawazoe, T.
Masui. Japanese Journal of Anesthesiology 49(4): 383-390
2000
ISSN/ISBN: 0021-4892 PMID: 10793523 Document Number: 513111
Transfusion of the irradiated blood has become popular in Japan to prevent the graft-versus-host disease. Case reports, however, of hyperkalemic death or lethal ECG change have been increasing since the irradiated blood was introduced nationwide. The potassium concentration of the supernatant of irradiated blood becomes about 60 mEq cntdot l-1 by the end of storage period. If the potassium concentration is 60 mEq cntdot l-1, the estimated safe transfusion rate would be 6 ml cntdot min-1 and this can not be agreed with clinicians who transfuse daily in cases of massive bleeding. The calculated safe transfusion rate (10 mEq cntdot hr-1 of potassium load) ranges from 6 to 72 ml cntdot min-1 considering the storage period from the day of gathering and irradiation. This difference could affect the survival rate. On the other hand, only the difference of the potassium concentration in the supernatant between the irradiated blood and the non-irradiated blood could not explain the increasing number of hyperkalemic case report. The mechanical factors may be related to hemolysis that causes extreme hyperkalemia. Control studies of proper transfusion rate of irradiated blood should be performed to establish a safety guideline for rapid transfusion of irradiated blood.