Application of the ADVIA Cerebrospinal Fluid Assay to Count Residual Red Blood Cells in Blood Components

Background And Objectives: There is no automated, accurate assay for the enumeration of residual red blood cells (rRBCs) in non-RBC components for transfusion, despite the potential risk of allo-immunization when mismatched components are transfused.

Materials And Methods: The automated ADVIA 120 cerebrospinal fluid (CSF) assay, which is approved to count RBCs and WBCs in CSF samples, was optimized and tested to measure rRBC in platelet concentrate (PC) and plasma components.

Results: Sample dilution, incubation time and reagent volume were optimized for use with non-RBC blood products. The assay was linear (R(2) = 0·99), even at low rRBCs counts. Intra- and inter-assay variation gave coefficients of variance (CV) between 2·2 and 9·4% and 2·6 and 14·9%, respectively, depending on rRBC levels. Good correlation (r = 0·995) was found between the automated assay and manual counting, which is considered the gold standard. Using the automated assay, the range of rRBCs (count/unit) in buffy-coat platelet concentrate (PCs) was 27-5505 × 10(6) and in apheresis PCs was 1-361 × 10(6).

Conclusion: The ADVIA CSF assay is a sensitive, precise and accurate means to assess rRBC counts in non-RBC components.