Abstract:
Blood bag is a medical device that must be safe and be acceptable according to the standard for clinical used. The imported blood bags from oversea should pass the safety assessment of ISO 10993-5 or the guideline from public health ministry and TIS 1298-2555. This study aimed to investigate the safety of quadruple blood bags from 3 manufacturers (Vietnam, India and Japan). The safety test was performed according to ISO 10993-5 emphasizing on acute cytotoxicity assay, subchronic assay, chronic assay and genotoxicity assay using mouse fibroblast L929 cell line. Acute toxicity assay revealed that all blood bag materials demonstrated toxicity at level 1 (slight) and 2 (mild) based on agar diffusion and direct contact assay, respectively. Cells contacted with extract samples also exhibited cell viability more than 70% from all 3 tested samples using MTT assay and cell morphology revealed toxicity at level 2 (mild) at the sample concentration of 0.2 g/ml. This demonstrated that blood bag materials of 3 sample sources were no cytotoxic. The subchronic and chronic assay were performed under simulation on the actual use of blood bags, medium represented as blood was feed into blood bag and the collected samples from bags of red blood cell and platelet were tested on cell viability using MTT assay. The cell morphology after extract samples incubation for 24 hr revealed toxicity grade at level 1 (slight) with cell viability greater than 70% at the sample concentration of 1:5 fold of sample. Subchronic and chronic toxicology assay were also performed using colony forming assay. The cell revealed percentage of plating efficiency at more than 70% after exposure to samples at the sample concentration of 1:5 fold of solution, for 1 or 2 repetitive treatment. This implied that repeated use of blood bags has no effect on cell growth. The genotoxicity of the samples were performed using micronuclei assay. All test condition provided NDI> 1, implying cell undergo proliferation in cell cycle. The frequency of micronuclei from cell exposured to sample was lower than that exposured to colchicine. It can be concluded from all results that all tested blood bags meet acceptable safety criteria according to the TIS 1298-2555 and ISO 10993-5.