White particulate matter found in blood collection bags consist of platelets and leukocytes

BACKGROUND: In late January 2003, some blood centers and hospitals throughout the US voluntarily sus‐pended the use of some RBC and plasma units for trans‐fusion due to the presence of unknown white particulate matter (WPM) in these units. To better understand the WPM phenomena, a number of technol...

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Published in:	Transfusion (Philadelphia, Pa.) Vol. 44; no. 7; pp. 959 - 966
Main Authors:	Rentas, F.J., Macdonald, V.W., Rothwell, S.W., McFaul, S.J., Asher, L.V., Kennedy, A.M., Hmel, P.J., Meledandri, C.J., Salata, J.M., Harman, R.W., Reid, T.J.
Format:	Journal Article
Language:	English
Published:	Oxford, UK and Malden, USA Blackwell Science Inc 01-07-2004 Blackwell Publishing
Subjects:	Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Blood Platelets Blood Specimen Collection Blood Transfusion Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis Cell Aggregation Filtration Flow Cytometry Humans Leukocytes Medical sciences Microscopy Spectrophotometry, Infrared Transfusions. Complications. Transfusion reactions. Cell and gene therapy Leukocyte Platelet Transfusion
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Summary:	BACKGROUND: In late January 2003, some blood centers and hospitals throughout the US voluntarily sus‐pended the use of some RBC and plasma units for trans‐fusion due to the presence of unknown white particulate matter (WPM) in these units. To better understand the WPM phenomena, a number of technologies were used to establish the nature of the particulates observed in Terumo Collection sets. STUDY DESIGN AND METHODS: All AS‐5 nonleuko‐reduced RBCs and plasma units were visually inspected for WPM by placing the bags on a flat counter, undisturbed, for approximately 10 minutes and then perform‐ing a visual examination for particles. Particles were isolated and placed on microscope slides or in plastic tubes for further analysis. Electron microscopy, bright field microscopy, differential interference contrast microscopy, infrared spectroscopy, and flow cytometry procedures were performed to establish the nature of the particulate matter. In addition, leukoreduction filters and blood transfusion sets were used on RBCs units with WPM. RESULTS: The particles were mostly composed of PLTs and WBCs, and fragments of these cells. All macroscopic WPM was removed from RBCs with leukoeduction and transfusion filters. CONCLUSIONS: WPM originated from PLTs and WBCs. Foreign matter (e.g., plastic) was not observed in any of the units. Leukoreduction and transfusion filters can be used to remove macroscopic WPM.
Bibliography:	This work was supported by the US Army Combat Casualty Care Research Program, Medical Research and Materiel Com-mand. The opinions expressed herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of the Army or the Department of Defense. This is US Government work; there is no copyright. ark:/67375/WNG-B4GDWMCN-J ArticleID:TRF03398 istex:1325F33DD2CAE8EC53113E36599BA432E7238DF4 This work was supported by the US Army Combat Casualty Care Research Program, Medical Research and Materiel Com‐mand. The opinions expressed herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of the Army or the Department of Defense. This is US Government work; there is no copyright. TRANSFUSION 2004;44:959‐966. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0041-1132 1537-2995
DOI:	10.1111/j.1537-2995.2004.03398.x