Whole blood storage in citrate and phosphate solutions containing half‐strength trisodium citrate: Cellular and biochemical studies

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Abstract
The efficacy of whole [human] blood preservation in acid citrate dextrose (ACD-A) and citrate-phosphate dextrose (CPD) anticoagulants containing half-strength trisodium citrate concentrations, was determined by biochemical and cellular assessment during 28 day storage at 4-6.degree. C. Erythrocyte 2,3-DPG 2,3-[diphosphoglycerate] and ATP concentrations, serum potassium, plasma Hb and blood pH values were similar between the standard and half-strength citrate counterpart in ACD-A and CPD series throughout the entire storage period. Erythrocyte indices (MCV [mean corpuscular volume], MCH [mean corpuscular Hb], MCHC [mean corpuscular concentration] and osmotic fragility) and the red cell, platelet, and leukocyte counts were also similar regardless of the final citrate concentration in ACD-A and CPD series during the 28 day storage period. Tests of coagulation (PT [prothrombin time], KCCT, TT [thrombin time] and ethanol gel) and fibrinogen levels were also similar, except for a lower quantity of clottable fibrinogen at day 28 in half-strength CPD. The formation of platelet and leukocyte aggregates during storage, as measured by changes in the SFP [screen filtration pressure], was similar in magnitude whether or not the half-strength citrate formulation was used in ACD-A or CPD. Phagocytic and bactericidal capacity against Staphylococcus aureus was normal following 24 h storage at 4-6.degree. C in ACD-A and CPD preserved blood, regardless of the final citrate concentration. Citrate quantity presently used during blood storage should probably be reduced to provide a safe, effective transfusion product for routine use.
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