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Ascorbate-2-phosphate in red cell preservation. Clinical trials and active components
G L Moore1, D H Marks, R A Carmen
1Division of Blood Research, Letterman Army Institute of Research, Presidio of San Francisco, California.
Transfusion
|May 1, 1988
Summary
A new red cell additive solution (AS-005) containing ascorbate-2-phosphate (AsP) showed comparable red blood cell viability to Nutricel AS-3 in clinical trials. In vitro, oxalate within AsP was found to preserve 2,3-diphosphoglycerate during storage.
Area of Science:
- Blood banking and transfusion medicine
- Biochemistry of red blood cells
- Preservation solutions
Background:
- Maintaining red blood cell (RBC) viability and function during storage is critical for transfusion efficacy.
- Additive solutions play a key role in extending RBC shelf life and preserving key metabolic parameters.
- Ascorbate-2-phosphate (AsP) has been investigated as a component to enhance RBC storage.
Purpose of the Study:
- To evaluate the efficacy of a novel red cell additive solution (AS-005) containing AsP for RBC storage.
- To compare the performance of AS-005 against a control additive solution (Nutricel AS-3) in human clinical trials.
- To investigate the in vitro effects of AS-005 on RBC parameters and identify the active component responsible for preserving 2,3-diphosphoglycerate (2,3-DPG).
Main Methods:
- Human clinical trials using a crossover design comparing AS-005 and Nutricel AS-3.
- Evaluation of RBC viability at 35 and 42 days of storage.
- In vitro split-bag studies of AS-005 at different storage temperatures (2.5°C and 5.5°C).
- Analysis of in vitro parameters including 2,3-DPG, glucose, pH, and adenosine triphosphate (ATP).
- High-pressure liquid chromatography (HPLC) to identify components in AsP preparations.
Main Results:
- No significant difference in red cell viability was observed between AS-005 and Nutricel AS-3 at 35 or 42 days in clinical trials.
- In vitro studies showed significant differences in 2,3-DPG (threefold), glucose (fivefold), pH, and ATP between storage conditions.
- HPLC confirmed the presence of 1-2% oxalate in AsP preparations.
- In vitro data indicated that oxalate is the active component in AsP responsible for preserving 2,3-DPG.
Conclusions:
- AS-005 demonstrates comparable red blood cell viability to Nutricel AS-3 in clinical settings.
- Oxalate, present in AsP, is identified as the key component preserving 2,3-DPG during RBC storage.
- Further research may be warranted to optimize additive solutions for enhanced RBC preservation.