The role of electrolytes and pH in RBC ASs.

Area of Science:

• Biomedical Science
• Blood Preservation
• Red Blood Cell Metabolism

Background:

• Experimental additive solutions (EASs) support red blood cells (RBCs) for extended periods.
• Current EAS formulations containing saline, adenine, glucose, mannitol, and disodium phosphate allow storage for 9-10 weeks.
• The impact of electrolyte composition and volume variations in EASs on RBC viability requires further investigation.

Purpose of the Study:

• To explore the effects of varying electrolyte composition and volume in experimental additive solutions (EASs) on red blood cell (RBC) preservation.
• To determine the optimal conditions for maintaining RBC ATP concentrations and minimizing hemolysis during extended storage.

Main Methods:

• Three four-arm studies were conducted involving pooled and realiquoted RBC units.
• Study 1: RBCs stored for 11 weeks in EAS with varying sodium bicarbonate (0-30 mmol/L).
• Study 2: RBCs stored for 9 weeks in EAS with varying sodium chloride (26-150 mmol/L).
• Study 3: RBCs stored in 100 or 200 mL of AS-3 or EAS-61.
• RBC Adenosine Triphosphate (ATP) concentrations and hemolysis were measured weekly.

Main Results:

• Increased sodium bicarbonate in EAS elevated pH and improved RBC ATP levels in later storage phases, without affecting hemolysis.
• Higher sodium chloride content in EAS reduced RBC ATP concentrations and increased hemolysis.
• EAS-61 demonstrated superior performance, increasing RBC ATP throughout storage and reducing hemolysis compared to AS-3.

Conclusions:

• Red blood cell (RBC) ATP synthesis is significantly influenced by the pH of the additive solution (AS).
• Hemolysis during RBC storage is sensitive to the salt content and volume of the additive solution (AS).
• Specific electrolyte compositions and volumes in EAS can enhance RBC viability during preservation.