title: Manufacture of red cells in additive solution from whole blood refrigerated for 5 days or remanufactured from red cells stored in plasma.
abstract: OBJECTIVE
  To investigate methods for the production of red cell concentrates (RCC) in saline, adenine, glucose and mannitol (SAG-M), from whole blood or red cells stored in plasma for 5 or 6 days and to provide evidence that exchange transfusion RCC in citrate phosphate dextrose (CPD) plasma or citrate, phosphate, dextrose, adenine (CPDA-1) plasma are of comparable quality.
  
  
  METHODS
  Ten RCC in SAG-M were produced following the remanufacture of red cells in CPD plasma on day 5/6 or after 5 days hold as leucodepleted CPD whole blood. In addition, 10 RCC in CPD plasma and 9 in CPDA-1 plasma were stored without further processing. Units were assessed for red cell parameters including haemolysis, adenosine triphosphate (ATP), 2,3-diphosphoglycerate (2,3-DPG) and extracellular potassium.
  
  
  RESULTS
  Units in SAG-M produced by remanufacture of RCC in plasma or by delayed manufacture of whole blood had comparable levels of haemolysis, ATP and 2,3-DPG. Furthermore, these units underwent biochemical changes similar to reference SAG-M units, with the exception of haemolysis which was greater at the end of shelf life and supernatant potassium which was lower following remanufacture. As expected, the decline in ATP was greater in red cells stored in CPD plasma compared with CPDA-1 plasma. In general, units in CPD plasma were of similar quality at day 28 compared to those in CPDA-1 plasma at day 35.
  
  
  CONCLUSIONS
  RCC produced following the remanufacture of RCC in plasma or the delayed manufacture of whole blood are of acceptable in vitro quality and should be assigned the same shelf life as standard RCC in SAG-M.
authors.affiliation: Components Development Laboratory, NHS Blood and Transplant, Brentwood, UK. michael.wiltshire@nhsbt.nhs.uk
authors.forename: Michael
authors.initials: M
authors.lastname: Wiltshire
authors.forename: Rebecca
authors.initials: R
authors.lastname: Cardigan
authors.forename: Stephen
authors.initials: S
authors.lastname: Thomas
mesh_terms: D019794:2,3-Diphosphoglycerate / Q000097:blood; D000225:Adenine / Q000494:pharmacology*; D000255:Adenosine Triphosphate / Q000097:blood; D000328:Adult; D000925:Anticoagulants / Q000494:pharmacology; D001793:Blood Preservation / Q000379:methods*; D002951:Citrates / Q000494:pharmacology*; D004906:Erythrocyte Count; D004912:Erythrocytes / Q000166:cytology / Q000187:drug effects* / Q000528:radiation effects; D005947:Glucose / Q000494:pharmacology*; D006801:Humans; D047589:Leukocyte Reduction Procedures; D008353:Mannitol / Q000494:pharmacology*; D010710:Phosphates / Q000494:pharmacology*; D010949:Plasma; D012034:Refrigeration; D012965:Sodium Chloride / Q000494:pharmacology*; D012996:Solutions / Q000494:pharmacology*; D013997:Time Factors
chemical_list: C037839:ADSOL; D000925:Anticoagulants; C034876:CPDA solutions; D002951:Citrates; D010710:Phosphates; D012996:Solutions; D019794:2,3-Diphosphoglycerate; D008353:Mannitol; D012965:Sodium Chloride; C007077:citrate phosphate dextrose; D000255:Adenosine Triphosphate; D005947:Glucose; D000225:Adenine