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What is the 'optimum' optimal additive solution?

J A Napier, P R Ashford, M M Hayward

    Vox Sanguinis
    |January 1, 1985
    PubMed
    Summary
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    Clotting in stored red blood cells is reduced by adding more citrate. Substituting SAG-M solution with a SAG-M/CPDA-1 mixture effectively minimizes clot formation in red cell suspensions.

    Area of Science:

    • Blood banking and transfusion medicine
    • Hematology
    • Biochemistry

    Background:

    • Spontaneous clot formation is an occasional issue in stored red blood cell units.
    • Larger amounts of clot have been observed in SAG-M (Saline, Adenine, Glucose, Mannitol) additive solutions.
    • The presence of residual plasma in red cell suspensions contributes to coagulation.

    Purpose of the Study:

    • To investigate the cause of increased clot formation in SAG-M suspensions.
    • To evaluate methods for reducing spontaneous clotting in stored red blood cells.
    • To determine if citrate levels affect coagulation in red cell suspensions.

    Main Methods:

    • Comparison of clot formation in SAG-M solutions versus modified solutions.
    • Analysis of red cell units stored in different additive solutions.

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  • Assessment of citrate concentration's role in inhibiting coagulation.

    • Main Results:

    • Substitution of SAG-M solution with a SAG-M/CPDA-1 mixture significantly reduced clot formation.
    • The findings suggest insufficient citrate in SAG-M solutions to fully inhibit residual plasma coagulation.
    • CPDA-1 (Citrate, Phosphate, Dextrose, Adenine) contains higher citrate levels.

    Conclusions:

    • Increasing citrate concentration in additive solutions can mitigate spontaneous clot formation in stored red blood cells.
    • A SAG-M/CPDA-1 mixture offers improved prevention of clotting compared to SAG-M alone.
    • Optimizing additive solution composition is crucial for maintaining the quality and safety of stored blood products.