長期間の低温保存中のアカゲザルおよびカニクイザル全血の評価

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 effects of prolonged 4°C storage of NHP WB.

WB was collected from 10 anesthetized male rhesus macaques and 5 male cynomolgus macaques into 10% CPDA-1 in 300 mL storage bags. WB units were tested at baseline prior to 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 manufacture of 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.