title: Pre-separation storage of whole blood: the effect of temperature on red cell 2,3-diphosphoglycerate and myeloperoxidase in plasma.
abstract: BACKGROUND
  Although whole blood intended for component preparation is commonly left to cool at ambient temperature, knowledge is insufficient concerning what effects this may have on red blood cell (RBC) quality, in particular after a prolonged hold.
  
  
  METHODS
  Whole blood collected in CPD was incubated at 20 degrees C and 28 degrees C for 6 h designed as a paired study. Blood components were prepared and the red blood cell concentrates (RBCs) were stored for 28 days at 4 degrees C +/- 2 degrees C. Blood gases, pH, glucose, lactate, adenosine triphosphate (ATP), 2,3-diphosphoglycerate (2,3-DPG) and plasma myeloperoxidase (MPO) were investigated.
  
  
  RESULTS
  After 6 h the 2,3-DPG concentrations had lowered to 88% (20 degrees C) and 54% (28 degrees C) of initial levels, respectively. The difference was significant and was maintained for 28 days, although, at low levels from day 7 (28 degrees C) and day 14 (20 degrees C) of storage. ATP was maintained at the initial level in both groups during the first 6 h of storage but after component separation the levels were significantly higher in the 28 degrees C group during the first 5 days. The release of myeloperoxidase (MPO) was significantly higher in the non-cooled group than in the cooled group.
  
  
  CONCLUSIONS
  Pre-separation holding for 6 h of whole blood at temperatures of 28 degrees C causes a great and rapid loss of 2,3-DPG and considerable formation of acid metabolites resulting in clearly subnormal 2,3-DPG levels even on day 1. Active pre-separation cooling to 20 degrees C is to be recommended.
authors.affiliation: Department of Clinical Immunology and Transfusion Medicine, University Hospital, Uppsala, Sweden. folke.knutson@klinimm.uu.se
authors.forename: F
authors.initials: F
authors.lastname: Knutson
authors.forename: H
authors.initials: H
authors.lastname: Lööf
authors.forename: C F
authors.initials: CF
authors.lastname: Högman
mesh_terms: D019794:2,3-Diphosphoglycerate / Q000097:blood*; D000255:Adenosine Triphosphate / Q000097:blood; D000925:Anticoagulants / Q000494:pharmacology; D001786:Blood Glucose / Q000032:analysis; D001793:Blood Preservation / Q000379:methods*; D002245:Carbon Dioxide / Q000097:blood; D002951:Citrates / Q000494:pharmacology; D004912:Erythrocytes / Q000737:chemistry*; D005947:Glucose / Q000494:pharmacology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007773:Lactates / Q000097:blood; D009195:Peroxidase / Q000097:blood*; D013696:Temperature; D013997:Time Factors
chemical_list: D000925:Anticoagulants; D001786:Blood Glucose; D002951:Citrates; D007773:Lactates; D019794:2,3-Diphosphoglycerate; D002245:Carbon Dioxide; C007077:citrate phosphate dextrose; D000255:Adenosine Triphosphate; D009195:Peroxidase; D005947:Glucose