Therapeutic effectiveness and safety of outdated human red blood cells rejuvenated to improve oxygen transport function, frozen for about 1.5 years at 80 C, washed, and stored at 4 C for 24 hours prior to rapid infusion

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Abstract
After storage at 4.degree. C for 20 to 28 days, [human] red blood cells [RBC] were biochemically modified to improve their O2 transport function, which had deteriorated during liquid storage. The solution used for rejuvenation contained pyruvate, inosine, glucose, phosphate and adenine (PIGPA Solution B). The rejuvenated RBC were frozen with 40% wt/vol glycerol in a polyolefin plastic bag and were stored in the frozen state for about 1.5 yr at -80 C. After thawing and washing, the RBC were stored at 4.degree. C in a NaCl glucose-phosphate solution for 24 h before transfusion. A pool of 4 to 10 units was rapidly transfused to each of 14 elderly anemic recipients, 11 of whom had cardiopulmonary insufficiency. Recovery of the RBC after the freeze-thaw process was about 97%, and after the freeze-thaw-wash process about 90%. The 24-h posttransfusion survival values were about 75%; the long-term survival values were about 85 days depending on the disease state of the recipient. The RBC had 1.5 times normal 2,3-DPG [2,3 diphosphoglycerate] levels and a decreased affinity for O2 at the time of transfusion and were able to deliver O2 at high O2 tension immediately after the rapid infusion of pools of from 4 to 10 units through a 40- or 170-micron filter. Plasma Hb levels were consistent with extravascular sequestration of nonviable RBC, and uric acid levels were not increased during the immediate 24-h posttransfusion period.