Red Cell Suspension (RCS)

Immunohematology | Laboratory

Red Cell Suspension

This provides the appropriate SERUM TO CELL RATIO to allow for grading and interpretation of tests results.

• To remove the unwanted plasma proteins including antibodies that might interfere in the reactions.

• To provide the appropriate serum to cell ratio to allow for grading and interpretation of tests results.

What is the purpose of preparing RCS?

Washed RBCs

These are RBCs that had most of the plasma, platelets, and white blood cells removed and replaced with saline or another type of preservation solution.

• Plasma

• Platelets

• WBC

What components are removed from Washed RBCs?

• Saline

• Other preservative Solutions

What replaces the removed components in Washed RBCs?

1. Repeatedly suspending the whole blood in NSS

2. Mixing

3. Centrifuging and Decanting the supernatant completely

The preparation of Red Cell Suspensions involves:

0.9% Normal Saline Solution

This is used because it is ISOTONIC with the RBC Cytoplasm.

RBC Cytoplasm

NSS is isotonic with the ___________.

0.9%

What percentage or concentration of NSS is used in preparing RCS?

Water will neither go in nor go out of the RBC

What is the effect of the ISOTONIC NSS on RBCs?

Water will move out of the cell via osmosis;

Crenated RBCs

What is the effect of a HYPERTONIC solution to RBCs?

Water will go in the cell;

Swelling & Hemolysis

What is the effect of a HYPOTONIC solution to RBCs?

FALSE

Many procedures require demonstration of antigen and antibody reactions in vitro.

TRUE or FALSE

Many procedures done in the laboratory do not require demonstration of antigen and antibody reactions in vitro.

2-5%

What percentage of RCS is universally employed as an indicator to display antigen-antibody reactions?

Agglutination is difficult to visualize
Weak Positive can fail to be detected

What is the effect of using a concentration of RCS that is TOO LOW?

It may mask weak agglutination

What is the effect of using a concentration of RCS that is TOO HIGH?

"“ADCR” - RCS

1. ABO and Rh Typing

2. Direct Antiglobulin Test

3. Compatibility Testing (Cross-Matching)

4. Red Cell Phenotyping

Give four (4) uses of Red Cell Suspension

“ADDR” - 2-5% RCS

1. ABO and Rh Typing

2. Direct Antiglobulin Test and Auto Control

3. Donor Unit Compatibility (Cross-Matching)

4. Red Cell Phenotyping

Give four (4) uses of 2-5% Red Cell Suspension

“DDII” - 0.8% RCS

1. Direct Antiglobulin Testing

2. Donor Unit Compatibility (Cross-Matching)

3. Indirect Antiglobulin Test

4. Identification Panel Test Cells

Give four (4) uses of 0.8% Red Cell Suspension

Whole Blood in EDTA

What specimen is used in preparing RCS?

1. Normal Saline Solution (0.85% - 0.9% NaCl)

   Phosphate-Buffered Saline (PBS)

2. Low Ionic Strength Solution (LISS)

   Other enhancement media

What reagents are used in preparing RCS?

1. Centrifuge

2. Serological Pipettes (1 mL, 3 mL, or 5 mL)

3. Graduated Pipettes or Micropipettes with Disposable Tips

4. Test Tubes (10 x 75 mm or 12 x 75 mm)

5. Test Tube Rack

6. Wash Bottle or Dropper for Saline or PBS

List the six (6) laboratory equipment used in preparing RCS.

1. Transfer 3 mL of EDTA blood in a test tube

2. Fill the test tube with NSS (3/4 of the tube)

3. Centrifuge for 1 minute at 3,400 rpm

4. Decant the supernatant saline solution in a quick manner

5. Avoid disturbing the PRBCs

6. Repeat 3-5x (steps 2-5)

7. Label clean test tube with patient’s name and desired concentration of RCS

8. Deliver 300 uL of washed patient’s red cells + 9,700 uL NSS in a test tube (TV: 10 mL)

9. Properly mix the suspension to achieve tomato red color (preferred)

Enumerate the nine (9) steps in performing RCS.

3/4

How much of the test tube should be filled with NSS?

3-5 times

How many times is the cell washing performed in RCS preparation?

3400 rpm for 1 minute

What is the centrifuge setting for RCS preparation?

Quick manner without disturbing the PRBCs

How will you decant the supernatant saline solution?

Tomato Red

What is the preferred color of the finished RCS procedure?

What is the formula to obtain the Packed Cell Volume?