Cell shape and total adenylate concentration as important factors for posttransfusion survival of erythrocytes

Red cells were stored for 42 days in a CPD/SAGM plastic bag system and then rejuvenated with bicarbonate, pyruvate and slow addition of adenosine. The reversibility and the time dependence of metabolic and morphologic changes were compared with autologous, posttransfusion survival. Total adenylates correlated better (r = 0.88) than ATP with viability in vivo ATP was better maintained when the blood was stored under anaerobic than aerobic conditions. A high correlation between morphology and viability was found in rejuvenated cells (r = 0.95). It is suggested that the time needed for reversal of changes is essential for viability.