Understanding the effects of gamma-irradiation on potassium levels in red cell concentrates stored in SAG-M for neonatal red cell transfusion.

BACKGROUND AND OBJECTIVES: Red cell transfusions, to paediatric patients, are often gamma-irradiated to prevent transfusion-associated graft-versus-host disease. This study measured changes in potassium and other in vitro parameters immediately following gamma-irradiation of paediatric and full-size red cell concentrates (RCCs). MATERIALS AND METHODS: The effects of irradiation on potassium release in RCCs stored in SAG-M were investigated under three scenarios. In the first scenario, RCC < 5 days was split into paediatric packs, gamma-irradiated and tested for potassium and haemolysis at 0, 2, 4, 6, 24 and 48 h. In the second scenario, full-size RCCs < 5 days postcollection were gamma-irradiated and tested as for the paediatric packs. Thirdly, RCCs < 14 days postcollection were gamma-irradiated and assessed at 6 and 24 h and 7 and 14 days. Each group contained paired controls that were not gamma-irradiated. RESULTS: In all situations, gamma-irradiation resulted in a twofold increase in potassium concentrations after 24 h of storage, compared to matched unirradiated controls. This difference was detectable as early as 2 h postirradiation. Few differences were observed between control and irradiated RCCs in other key parameters, including ATP, 2,3-DPG, haemoglobin, pH, glucose and lactate concentration. CONCLUSION: Gamma-irradiation of RCCs significantly increased extracellular potassium. Irradiation of fresher RCCs results in lower potassium concentrations, which is less likely to lead to hyperkalaemia upon transfusion.

The Role of Convalescent Plasma and Tocilizumab in the Management of COVID-19 Infection: A Cohort of 110 Patients from a Tertiary Care Hospital in Oman.

AIM: As Coronavirus Disease-2019 (COVID-19) pandemic continues to evolve, the search for safe and effective therapeutic interventions remain essential. METHODS: We conducted a retrospective cohort study on patients hospitalized with laboratory confirmed severe acute respiratory syndrome coronavirus-2 infection, comparing standard of care along with Convalescent Plasma with or without Tocilizumab (CP vs. CPT). RESULTS: A total of 110 patients were enrolled with an overall mean age of 50 ± 16 years. Patients on CPT were more likely to have had acute respiratory distress syndrome (77% vs. 42%; p < 0.001), sepsis (9.7% vs. 0; p = 0.036), chest X-ray abnormalities (71% vs. 44%; p = 0.004), intensive care unit admission (84% vs. 56%; p = 0.001) as well as being on mechanical ventilation (79% vs. 48%; p = 0.001). After CPT treatment, all measured inflammatory markers, except interleukine-6, showed an overall steady decline over time (all p-values <0.05) and the ventilatory parameters showed significant improvement of PaO2/FiO2 ratio from 127 to 188 within 7 days (p < 0.001). Additionally, 52% (32/62) of the patients had favorable outcome, either as improvement of ventilatory parameters or extubation within 14 days of hospitalization. However, mortality rate in those on CPT was higher than those who received CP alone (24% vs. 8.3%; p = 0.041). CONCLUSION: In patients with severe COVID-19 infection, using tocilizumab with convalescent plasma is associated with improvement in inflammatory and ventilatory parameters but no effect on mortality. These findings require validation from randomized clinical trials.