Evaluation of Rhesus and Cynomolgus Macaque Whole Blood During Prolonged Cold Storage

Care for massively bleeding patients has seen a return of focus to the use of cold-stored whole blood (WB) as the primary resuscitation treatment. Nonhuman primates (NHP) are the ideal trauma animal model for preclinical hemostatic research as they are most physiologically akin to humans, yet study designs use autologous shed WB, which does not fully recapitulate what occurs in human medicine. We sought to evaluate the effects of prolonged 4°C storage of NHP WB.

WB was collected from 10 anesthetized male rhesus macaques and five male cynomolgus macaques into 10% citrate phosphate dextrose adenine in 300 mL storage bags. WB units were tested at baseline before storage at 4°C and aseptically sampled daily for the first 4 days, then weekly at day 7 through day 28 of storage. Biochemical, hematologic, and hemostatic function parameters were assayed. Data were analyzed using a mixed-effects analysis with multiple comparisons if significant.

In both species, red cell, hemoglobin, and hematocrit counts remained stable through day 28, while lactate and potassium levels significantly increased as sodium and pH decreased significantly. Hemostatic function significantly declined for both species from day 7 onward.

This study describes a viable method of manufacturing NHP stored WB and characterizes the storage lesion in both rhesus and cynomolgus macaques. Observationally, no overt differences were seen between species. Future resuscitation studies utilizing NHP models could improve translational relevance using stored allogenic WB.