Abstract:
Background. The high prevalence of haemoglobin variants and glucose 6-phosphate dehydrogenase disorder (G6PDd) in sub-
Saharan Africa means that substantial proportions of donor blood units carry these red cell abnormalities. Aim. This study
investigated the impact that inherited haemoglobin variants and/or G6PD status have on whole blood banked at 4–6°C for 35 days.
Method. This repeated-measure cohort study was undertaken on 103 donor blood units collected into blood bag containing
CPDA-1 anticoagulant. On days 0, 7, 14, 21, and 35, full blood count, osmotic-induced haemolysis, and plasma K+ levels were
estimated. Also, on day 0, G6PD status, haemoglobin variants, % foetal haemoglobin, and blood group of donor units were
determined using methaemoglobin reductase, cellulose acetate electrophoresis, modified Bekte alkali denaturation assay, and slide
haemagglutination test, respectively. Result. Overall, although plasma K+ levels increased during storage, donor units from
individuals ≥20 years, G6PD normal, Hb AC, or blood group B had comparatively higher percentage change in plasma K+ during
storage. Osmotically induced haemolysis of donor units was significantly decreased in Hb AC (compared with Hb A or AS) donor
units on days 7, 14, 21, and 35 (p < 0.0001 in each case). G6PDd donor units had comparatively reduced osmotic-induced lysis
compared with G6PD normal units, reaching a statistical significance on day 35 (p � 0.043). Also, Hb AC units had comparatively
nonstatistically higher plasma K+ at all time points (compared with Hb A or AS). Furthermore, whereas donor units from
individuals ≥20 years showed significantly higher median free haemoglobin on day 21 (compared to donor <20 years), when
donor units were stratified per Hb variants, only Hb AS units had median free haemoglobin below the 0.8% threshold after 35
days’ storage. Conclusion. Age of donor, blood group, Hb AC variant, and G6PD status may be important considerations in the
storability of whole blood.
