International Society of Radiolabeled Blood Elements



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Question from Hind Al-Otaibi (
Subject: Query about WBC labelling Plasma Expander
Date: Tue, 30 Oct 2012 11:27:40 +0300

Dear Dr. Sobal,
I would like to ask about the plasma expander used in the white blood cells labeling . In our lab we are using 6%  Hetastarch(Hydroxyethyl starch ( HES 130/ 0.4) )IN ISOTONIC SODIUM CHLORIDE solution .
Ingredients in detail are:
Poly( o-2-hydroxyethyl) starch      60.00 g
Molar substitution                              0.38 – 0.45
Mean molecular weight =                130,000
Sodium chloride                               9.00 g
Electrolytes Na+                   154 mmol/l                Cl  154 mmol/l
Theoretical osmolarity                  308 mosm/l
Titratableacidity                         < 1.0 mmol NaOH/l
 PH:                                                     4.0 – 5.5
I would appreciate it if you see the above ingredients and tell me is it the  right concentration to be used for erythrocyte sedimentation in the white blood cells labeling procedure.
Many thanks and kindest regards
Hind Al-Otaibi
Chief Specialist of Nuclear Hematology Lab
Mubarak Al-Kabeer Hospital, Ministry of Health – KUWAIT

Answer from Napoleone Prandini:


In my opinion the best product to obtain a fast sedimentation of RBC for leukocytes labelling is the HAES Steril 10%: you can find all the informations about the chemical composition and clnical effects on WEB page:


1 litre contains:

Medicinal active ingredients:
Poly (0-2-hydroxyethyl) starch 100.00 g,
Degree of substitution 0.40-0.55,
Average moleculare weight Mw: 200.000,
Active ingredients: Sodium chloride 9.00 g,
Na+: 154 mmol/L, Cl : 154 mmol/L
Other ingredients: Sodium hydroxide, Hydrochloric acid, water,
Titration acidity: < 1 mmol NaOH/L,
Theoretical osmolarity: 308 mosm/L,
pH value: 3.5-6.0 

Further Information: Description of HAES-steril®6% and HAES-steril®10%:
Hydroxyethyl starch (HES) is manufactured from amylopectin, and is characterized by molecular weight, degree of substitution and plattern of substitution. The average molecular weight Mw is approx. 200,000 dalton, and the degree of substitution is approx. 0.5 i.e. approx. 5 hydroxyethyl groups are present in 10 glucose units of the amylopectin skeleton, mainly in position C2. The C2/C2 ratio is 5:1. The main chains in HES (poly(0-2-hydroxyethyl) starch) are made up of alpha 1.4-linked glucose units and branched via alpha-1.6-bonds. On basis of its close structural relationship to glycogen a high somatic tolerance and only a low risk of anaphylactoid reactions may be anticipated for HAES-steril® 6%. HAES-steril® 6% is characterized by the high stability of the solution, and does not flocculate in the event of temperature fluctuations.

Further information or references available from:
Intramed (Division of Pharmacare Ltd),
Druggists Park, Woodlands Drive,
Woodmead, Sandton.
Tel: (011) 239-3400; Fax: (011) 239-3472

Nuclear Medicine Dept.

University Hospital PoliclinicodiModena

delPozzo 71 – 41124 Modena

Phone: +39 – 059 – 4222330

Fax: +39 – 059 – 4224128

Personal: +39 – 059 – 4225104



Dr. Funda AYDIN has successfully completed the course on “CERTIFICATE PROGRAM ON RADIOLABELING OF BLOOD ELEMENTS” organized by ISORBE, andNuclear Medicine Department of the Akdeniz University,  Antalya, Turkey on 27-29 March 2011 and fulfilled all the requirements defined by the ISORBEnecessaryto take responsibility for the radiolabeling of bloodcells.

Here are the copies of her certificate and some words from the ISORBE educational committee:

– After completion of the Certificate Course in AntalyaTurkey, 27-29 March 2011 Dr. Funda Aydin has reported her results. Enclosed please find labeling of 15 WBC’s and 5 WBC images and the required forms which meet our requirements for Certification.
I propose to award her with an ISORBE Certificate.
Kutlan Özker, PhD

WBC labeling efficiencies:
Case 1: 86%, Case 2: 92%, Case 3: 94%, Case 4: 88%, Case 5: 90%
Case 6: 82%, Case 7: 88%, Case 8: 78%, Case 9: 92%, Case 10: 90%
Case 11: 86%, Case 12: 76%, Case 13: 85% , Case 14: 82%, Case 15: 60%
*We would like to thank ISORBE presidium for organizing the course and MEDI-RADIOPHARMA, HUNGARY for supporting the kits.
Dr.Funda Aydın
Akdeniz University Medical School
Department of Nuclear Medicine Antalya/TURKEY 

  • – Excellent the labelling efficiency & images- Funda really did a good job. Of course she deserves the ISORBE certificate.   Congratualtions KUTLAN & FIRAT. Dra Victoria E. Soroa

– Excellent! I agree.  Dr. Helmut Sinzinger

– Excellent work. Congratulation to Funda and Firat. Evaluation passed.  Dr. J. Martin Comin

– I agree. Dr. Chris Palestro



Ms. Leena DEEB has been awarded with an ISORBE Certificate based on her completion of CERTIFICATE PROGRAM ON RADIOLABELING OF BLOOD ELEMENTS in Antalya, Turkey on 27-29 March 2011 and meeting all the requirements defined by the ISORBE necessary to take responsibility for the radiolabeling of blood cells.
Here are the copies of her certificate and some words from the ISORBE educational committee describing her performance:

·        Ms. Leena Deeb has been working on radiolabeled blood cells for several years in Kuwait. She has worked very hard to introduce proper conditions for blood cell radiolabeling and finally reported excellent results. I propose to award her with an ISORBE Certificate.
Kutlan Özker, PhD

·        The LE was quite high and the image quality of Leena’s work is excellent. Dr. J. Martin Comin

·        Excellent work has been achieved by Leena. Never better deserved the Certificate. Dr. Victoria Soroa

·        The data by Leena are really excellent. Dr. Helmut Sinzinger

·        I agree. Dr. Chris Palestro

·        I agree too. Dr. Firat Güngör



On April 4th, 2011 Grazyna SOBAL from the Department of Nuclear Medicine, Medical University of Vienna, Austria achieved the academic title “Privatdozent” in medical chemistry.