Objective: To facilitate further assessment of transfusion-associated lead exposure by designing a procedure to test packed red blood cells (pRBCs) prepared for transfusion.
Study design: The relationship between pRBCs and whole blood lead concentration was investigated in 27 samples using a modified clinical assay. Lead concentrations were measured in 100 pRBC units.
Results: Our sample preparation method demonstrated a correlation between whole blood lead and pRBC lead concentrations (R(2) = 0.82). In addition, all 100 pRBC units tested had detectable lead levels. The median pRBC lead concentration was 0.8 μg/dL, with an SD of 0.8 μg/dL and a range of 0.2-4.1 μg/dL. In addition, after only a few days of storage, approximately 25% of whole blood lead was found in the supernatant plasma.
Conclusion: Transfusion of pRBCs is a source of lead exposure. Here we report the quantification of lead concentration in pRBCs. We found a >20-fold range of lead concentrations in the samples tested. Pretransfusion testing of pRBC units according to our proposed approach or donor screening of whole blood lead and selection of below-average units for transfusion to children would diminish an easily overlooked source of pediatric lead exposure.
Keywords: CDC; Centers for Disease Control and Prevention; ICP-MS; Inductively coupled plasma mass spectrometry; Packed red blood cell; VUMC; Vanderbilt University Medical Center; WHO; World Health Organization; pRBC.
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