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Washed Red Blood Cells

Red blood cells are washed, using isotonic saline solutions, by either automated or manual techniques. Automated techniques are more efficient, but there is always some degree of red blood cell loss with each wash cycle. When the washing is performed in an open system, the resulting product must be transfused within 24 hours because of concerns over potential bacterial contamination.

The primary aim of washing is to remove plasma proteins, although some leukocytes and platelets are removed simultaneously. The major indication for washed red blood cells is the prevention of severe allergic transfusion reactions, thought to be mediated by recipient antibodies (most likely IgE) to donor plasma proteins. Washing is recommended when reactions are recurrent and severe, even in the face of antihistamine administration. In IgA-deficient patients who have preformed antibody to IgA, IgA-containing plasma can actually cause anaphylaxis.[34]Multiple cell washes may be required …