Prolonged maintenance of 2,3-diphosphoglycerate acid and adenosine triphosphate in red blood cells during storage.
BACKGROUND
Current additive solutions (ASs) for red cells (RBCs) do not maintain a constant level of critical metabolites such as adenosine triphosphate (ATP) and 2,3-diphosphoglycerate acid (2,3-DPG) during cold storage. From the literature it is known that the intracellular pH is an important determinant of RBC metabolism. Therefore, a new, alkaline, AS was developed with the aim to allow cold storage of RBCs with stable product characteristics.


METHODS
Whole blood-derived RBCs (leukoreduced) were resuspended in experimental medium phosphate-adenine-guanosine-glucose-gluconate-mannitol (PAGGG-M; pH 8.2) with and without washing in the same medium. During cold storage several in vitro variables, such as intracellular pH, 2,3-DPG, ATP, and hemolysis, were analyzed.


RESULTS
During cold storage, RBCs resuspended in PAGGG-M showed a constant ATP level (approx. 6 mumol/g Hb) and a very limited hemolysis (<0.2%). The 2,3-DPG content showed an increase until Day 21 (150% of initial level), followed by a slow decrease, with at Day 35 still 100 percent of the initial level. RBCs washed in PAGGG-M even showed a continuous increase of 2,3-DPG during 35 days, with a maximum level of 200 percent of the initial value. The effect of PAGGG-M appears to be related to long-lasting effects of the initial intracellular pH shortly after production.


CONCLUSIONS
Resuspension of RBCs in our alkaline medium PAGGG-M resulted in a RBC unit of high quality during storage for up to at least 35 days, with 2,3-DPG levels of higher than 10 mumol per g Hb, hemolysis of less than 0.2 percent, and ATP levels of higher than 5 mumol per g Hb.
de Korte
Dirk
D
Sanquin Research, Amsterdam, The Netherlands. d.dekorte@sanquin.nl
Kleine
Mya
M
Korsten
Herbert G H
HG
Verhoeven
Arthur J
AJ
D019794:2,3-Diphosphoglycerate / Q000378:metabolism*; D000255:Adenosine Triphosphate / Q000378:metabolism*; D001793:Blood Preservation / Q000379:methods*; D048430:Cell Shape / Q000187:drug effects; D004912:Erythrocytes / Q000166:cytology / Q000378:metabolism*; D006461:Hemolysis; D006801:Humans; D006863:Hydrogen-Ion Concentration; D011188:Potassium / Q000494:pharmacology; D013997:Time Factors
D019794:2,3-Diphosphoglycerate; D000255:Adenosine Triphosphate; D011188:Potassium