Prolonged storage of red cells at 4° C

Abstract

One of the events associated with red cell storage at 4 degrees C is the development of an increasing proportion of echinocytes. Vesicles also may bud off the spicules, presumably leading to a decreased surface-to-volume ratio and decreased deformability. Pursuing the hypothesis that increasing the surface tension of the cells by increasing their volume might reduce the tendency toward echinocytosis and extend refrigerated storage time, packed red cells were resuspended in a solution hypotonic (210 mOsm) with respect to solutes that do not penetrate the cell. Since a reduced ionic concentration results in increased membrane permeability for cations, normal ionic concentration was maintained by the addition of NH4C1, which readily penetrates red cells and therefore contributes no osmotic support. Adenine, glucose, mannitol, citrate, and phosphate also were included. Unexpectedly, the predominant effect of red cell storage in this solution was a remarkable elevation of adenosine triphosphate (ATP). At 4, 8, and 10 weeks, (ATP) levels averaged 165, 135, and 110 percent of initial values, respectively. At 16 weeks, ATP still averaged 50 percent of initial values. Twenty-four-hour in vivo survival of red cells measured at 12 to 18 weeks ranged between 70 and 80 percent, and hemolysis ranged from 0.3 to 7.1 percent. Both the hypotonicity and the ammonium salt appear to be necessary for the high ATP.

Refrigerated Storage of Washed Red Cells

“…In a previous publication [6] we described a red-cell resuspension solution that substantially extended the main tenance of ATP and yielded 24-hour in vivo survival ex ceeding 75% for as long as 14 weeks. The solution was hypotonic for solutes that do not penetrate the red cell and contained ammonium chloride in addition to sodium or potassium phosphate, glucose, mannitol and adenine at a pH of 7.1.…”

Studies in Red Blood Cell Preservation 10.(51)Cr Recovery of Red Cells after Liquid Storage in a Glycerol-Containing Additive Solution

“…Another factor acting in the same direction is the swelling of the cells in the hypotonic medium. Meryman et al [24] have suggested that the increase in surface tension could suppress the shedding of vesicles. A secondary effect of the decreased loss of cell membrane is the better mainte nance of cholesterol and phospholipids (unpublished data).…”

Natural Antioxidants Improve Red Blood Cell “Survival” in Non-Leukoreduced Blood Samples

“…Literature data showed that antioxidants given either to blood donors [47] or to storage solutions [2,48] improve RBCs storage parameters by reducing free radical cell damage. The most promising results could be expected when antioxidants effectively inhibit cation leakage [49,50].…”

“…Beside the problems connected with sterility of the blood samples (the absence of pathogenic infection and viruses) there is a general problem of cell survival during the storage and after the transfusion. Cryopreservation of RBCs in highly concentrated glycerol media results in about 80% survival of de-frozen cells [1,2]. However, the method complexities (expensive materials used and post-storage cryoprotectant removal problems) limit the use of cryopreserved blood.…”