Recent developments in the long-term preservation of red blood cells

The first study to suggest the successful prolongation of the useful shelf life of red blood cells (RBCs) used a hypotonic additive solution containing glycerol. It was necessary to use twice the volume of this solution than the commercial additive solution per unit of packed RBCs. The final concentration of glycerol in the units was approximately 0.69% (75 mmol/L). A subsequent study demonstrated that the membranes of the exocytic microvesicles shed during storage had less of bands 3 and 4.1 than those in Adsol (Fenwal Laboratories, Deerfield, IL). Band 4.1 is important for strengthening the bonds between spectrin and actin in the cytoskeleton. In another study, glutamine or glutamine plus phosphate was used in a hypotonic additive solution, otherwise similar to the glycerol-containing additive. In the latter medium, phosphatidylethanolamine was less accessible to phospholipase action than in Adsol or when glutamine alone was added. Another group reported encouraging data regarding the action of L-carnitine when added to AS-3. Acylation of phosphatidylethanolamine mediated by the action of carnitine fatty acid transferase with acyl coenzyme A (acyl-CoA) occurred. Adenosine-5'-triphosphate levels and red cell recovery were better in the test units. In the last paper reviewed, the authors demonstrated that oxidant damage of erythrocytes was less if the donors were given a mixture of antioxidants for 10 days prior to donating.