Storage of red blood cells in alkaline PAGGGM improves metabolism but has no effect on posttransfusion recovery

Sanquin research and Landsteiner Laboratory, Netherlands. University Medical Center Utrecht, Netherlands. Amsterdam UMC, Amsterdam, Netherlands. Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands. Suez Canal University, Egypt. Sanquin Blood Bank, Amsterdam, Netherlands. Sanquin, Amsterdam, Netherlands. University of Colorado Denver, Aurora, Colorado, United States. University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, United States. Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands. Sanquin Blood Supply Foundation, Amsterdam, Netherlands. Sanquin Research, Amsterdam, Netherlands.

Blood advances. 2022
Abstract
Additive solutions are used to limit changes that red blood cells (RBCs) undergo during storage. Several studies have shown better preservation of glucose and redox metabolism using the alkaline additive solution PAGGGM (phosphate-adenine-glucose-guanosine-gluconate-mannitol). In this randomized open label intervention trial in 20 healthy volunteers, the effect of storage, PAGGGM versus SAGM (saline-adenine-glucose-mannitol), on post transfusion recovery (PTR) and metabolic restoration after transfusion was assessed. Subjects received an autologous biotinylated RBC concentrate stored for 35 days in SAGM or in PAGGGM. As a reference for the PTR, a 2-days stored autologous biotinylated RBC concentrate stored in SAGM was simultaneously transfused. RBC phenotype and PTR were assessed after transfusion. Biotinylated RBCs were isolated from the circulation for metabolomics analysis up to 24 hours after transfusion. The PTR was significantly higher in 2 days stored RBCs than in 35 days stored RBCs after 2 and 7 days after transfusion: 96% [90-99] versus 72% [66-89] and 96% [90-99] versus 72% [66-89] respectively. PTR of SAGM and PAGGGM stored RBCs did not differ significantly. Glucose and redox metabolism were better preserved in PAGGGM stored RBCs. Thedifferences measured in the blood bag remained present after transfusion only until one day after transfusion. No differences in RBC phenotype were found besides an increased complement C3 deposition on 35 days RBCs stored in PAGGGM. Our data indicate that despite better metabolic preservation, PAGGGM is not a suitable alternative for SAGM since storage in PAGGGM did not result in an increased PTR. Finally, RBCs that were recovered from circulation after transfusion showed reversal of the metabolic storage lesion in vivo within a day. This study is registered in the Dutch trial register (NTR6492).
Study details
Language : eng
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