Changes in adenosine triphosphate, 2,3 diphosphoglycerate, and P50 of dog blood following transfusion of autologous red cells pretreated with phosphoenolpyruvate in vitro

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Abstract
Red cells treated with phosphoenolpyruvate (PEP) in vitro were reinfused into the donor dogs and were monitored for changes in adenosine triphosphate (ATP), 2,3 diphosphoglycerate (2,3 DPG), and P50. ATP and 2,3 DPG concentrations increased to 116 and 143 percent of control, respectively, when these cells were incubated with 60 mM PEP for 90 minutes at 37.degree. C. The oxygen dissociation curve shifted to the right, and P50 increased from 24.5 to 30.6 torr as a result of the PEP treatment. When one-half of the circulating red cell volume was treated with PEP and reinfused into the animal, the red cell 2,3 DPG increased to 120 percent of pretransfusion values. The 2,3 DPG level remained elevated during the following day and returned to near pretransfusion levels on the third day. The P50 of the circulating blood paralleled the variations in the red cell 2,3 DPG level, and the capacity for oxygen delivery was calculated to be raised by 13 to 38 percent for a period of 24 hours. In contrast, elevated red cell ATP returned to control values immediately after transfusion. In vivo viability, i.e., 24-hour survival and one-half disappearance time, of the cells pretreated with PEP were determined by a single-isotope technique using 51Cr. The results showed that PEP treatment did not injure the red cells. In addition, there was neither acute toxicity nor a deleterious hemodynamic effect when large amounts of PEP were administered intravenously. These results suggest that PEP could be used clinically to improve the capacity of the circulating red cells to deliver oxygen to the tissues.