Five-week red cell storage with preservation of 2,3 DPG

Area of Science:

• Biochemistry
• Hematology
• Transfusion Medicine

Background:

• Red blood cell (RBC) storage leads to a rapid decrease in 2,3-diphosphoglycerate (2,3 DPG), impairing oxygen release.
• Ascorbic acid derivatives, like ascorbate-2-phosphate (A-2-P), are known to preserve erythrocyte 2,3 DPG during liquid storage.

Purpose of the Study:

• To evaluate the efficacy of a novel additive solution (AS-4) containing stabilized ascorbate-2-phosphate (A-2-P) in maintaining 2,3 DPG levels in stored RBCs.
• To assess the in vitro and in vivo viability and oxygen-offloading function of RBCs supplemented with AS-4.

Main Methods:

• Red blood cell concentrates were prepared from blood collected in citrate-phosphate-double-dextrose and supplemented with the AS-4 solution.
• 2,3 DPG and adenosine triphosphate (ATP) levels were measured over 5 weeks of storage.
• In vivo viability was assessed using 51Cr-labeled red cell recovery after 24 hours.

Main Results:

• The AS-4 additive solution maintained significantly higher 2,3 DPG levels compared to standard storage, with values at 82.3% of initial after 5 weeks.
• Adenosine triphosphate (ATP) levels decreased during storage, reaching 22.2% of initial values after 5 weeks.
• Despite low ATP, 24-hour red cell recoveries averaged 74.1% after 5 weeks of storage, indicating acceptable viability.

Conclusions:

• The AS-4 system effectively preserves 2,3 DPG in stored RBCs, enhancing oxygen-offloading capacity.
• The AS-4 system provides a red cell product with acceptable viability for transfusion, even after extended storage.
• This additive solution represents a promising advancement for improving the quality and function of stored blood products.