Alternative methods for calculating percentage haemolysis of red cell concentrates in peripheral blood banks in Sri Lanka

BACKGROUND: Haemolysis – one of the major limiting factors of red cell concentrate quality – must be measured as a quality-monitoring requirement. According to international quality standards, percentage haemolysis must be monitored in 1.0% of red cell concentrates produced monthly and maintained under 0.8%. OBJECTIVE: This study assessed three alternative methods for determining plasma haemoglobin concentration in peripheral blood banks that lack a plasma or low haemoglobin photometer – the gold-standard method – in Sri Lanka. METHODS: A standard haemolysate was prepared using an unexpired whole blood pack of normal haemoglobin concentration. A concentration series from 0.1 g/dL to 1.0 g/dL was prepared by diluting portions of standard haemolysate with saline. The alternative methods, namely visual haemoglobin colour scale, spectrophotometric calibration graph, and standard haemolysate capillary tube comparison, were designed using this concentration series and were used to test red cell concentrates received at the Quality Control Department of the National Blood Center, Sri Lanka, from February 2021 to May 2021. RESULTS: A strong correlation was observed between the haemoglobin photometer method and the alternative methods (R = ~0.9). Based on the linear regression model, the standard haemolysate capillary tube comparison method was the best of the three alternative methods (R(2) = 0.974). CONCLUSION: All three alternative methods are recommended for use in peripheral blood banks. The standard haemolysate capillary tube comparison method was the best model.