Lipid peroxidation compared in stored whole blood with various nutrient-anticoagulant solutions

Since the introduction of acid-citrate-dextrose (ACD) in 1947 to anticoagulate and preserve whole blood for transfusion, various improved formulas, such as citrate-phosphate-dextrose-adenine (CPDA-1), have been successfully introduced, extending the current acceptable blood storage time to 35 days. Additional nutrient-anticoagulant solutions, including CPDA-2, CPDA-3, AS-1, and AS-5, among others, have more recently been studied with comparable results. In this study, lipid peroxidation (LP) was compared, as determined by the measurement of plasma malondialdehyde (MDA) by liquid chromatography, in stored blood preserved with various nutrient solutions with blood treated with CPDA-1. Although minor but inconsistent differences were noted with most of these solutions compared with CPDA-1, AS-1 gave consistently lower MDA levels (P < 0.01). Further improvements in red cell storage and viability may require approaches other than nutrient formula variations, such as the addition of metal chelating agents or other selected antioxidants to the nutrient-anticoagulant solutions, donor supplementation with vitamin free radical scavengers, or other as yet undetermined conditions.