Biochemical and structural changes in RBCs stored with different plasticizers: the role of hexanol

Area of Science:

• Biomedical Science
• Hematology
• Materials Science

Background:

• Polyvinyl chloride (PVC) bags utilize phthalate plasticizers like DEHP, raising toxicity concerns.
• Butyryltrihexylcitrate (BTHC) is a proposed alternative plasticizer for PVC medical devices.
• Hexanol, a component of BTHC, was investigated for its role in red blood cell (RBC) preservation.

Purpose of the Study:

• To evaluate the efficacy of hexanol, a BTHC component, in preserving RBCs.
• To compare the effects of BTHC-plasticized PVC bags versus DEHP-plasticized PVC bags on RBC storage.
• To assess the impact of added hexanol, DEHP, and BTHC on RBCs stored in polyolefin (PO) bags.

Main Methods:

• WBC-reduced RBCs were stored in DEHP-plasticized (PL146), BTHC-plasticized (PL2209), and polyolefin (PO) bags for 6 weeks.
• AS-1 additive solution was used, with some PO bags supplemented with DEHP, BTHC, or hexanol.
• Measurements included RBC ATP levels, hemolysis, morphology, membrane lipids, deformability, and fluidity.

Main Results:

• No significant differences in RBC ATP levels were observed across storage systems.
• Hemolysis was lowest in PL146 (DEHP) and significantly reduced in PO bags with added DEHP, BTHC, or hexanol.
• Reduced vesicle accumulation was noted in BTHC- and DEHP-plasticized bags compared to PO bags.

Conclusions:

• Hexanol, as part of the BTHC plasticizer, significantly suppresses RBC hemolysis and vesiculation during storage.
• Leached DEHP and hexanol from plasticizers offer greater protection against hemolysis and vesicle formation than when added exogenously.