TY - JOUR
T1 - Storage of red blood cells in alkaline PAGGGM improves metabolism but has no effect on recovery after transfusion
AU - de Bruin, Sanne
AU - Peters, Anna-Linda
AU - Wijnberge, Marije
AU - van Baarle, Floor E. H. P.
AU - AbdelRahman, Amira H. A.
AU - Vermeulen, Christie
AU - Beuger, Boukje M.
AU - Reisz, Julie A.
AU - D'Alessandro, Angelo
AU - Vlaar, Alexander P. J.
AU - de Korte, Dirk
AU - van Bruggen, Robin
N1 - Funding Information: This study was supported in part by research funding from San-quin Bloodbank to A.P.J.V., A.L.P., R.B., and D.K. A.D. was supported by funds from the National Institute of General and Medical Sciences (RM1GM131968) and the National Heart, Lung, and Blood Institute (R01HL146442, R01HL149714, R01HL148151, and R21HL150032). Funding Information: The authors thank Rob Hoenderdaal, Brunette Daal, Davina Sijbrands, Jos Lorinser, Berend Hooibrink, Toni Capel, and Kim Brandwijk for technical support. This study was supported in part by research funding from Sanquin Bloodbank to A.P.J.V., A.L.P., R.B., and D.K. A.D. was supported by funds from the National Institute of General and Medical Sciences (RM1GM131968) and the National Heart, Lung, and Blood Institute (R01HL146442, R01HL149714, R01HL148151, and R21HL150032). Publisher Copyright: © 2022 by The American Society of Hematology.
PY - 2022/7/12
Y1 - 2022/7/12
N2 - 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 vs SAGM (saline-adenine-glucose-mannitol), on posttransfusion recovery (PTR) and metabolic restoration after transfusion was assessed. Subjects received an autologous biotinylated RBC concentrate stored for 35 days in SAGM or PAGGGM. As a reference for the PTR, a 2-day 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 the 2-day stored RBCs than in 35-day stored RBCs 2 and 7 days after transfusion: 96% (90 to 99) vs 72% (66 to 89) and 96% (90 to 99) vs 72% (66 to 89), respectively. PTR of SAGM- and PAGGGM-stored RBCs did not differ significantly. Glucose and redox metabolism were better preserved in PAGGGM-stored RBCs. The differences measured in the blood bag remained present only until 1 day after transfusion. No differences in RBC phenotype were found besides an increased complement C3 deposition on 35-day RBCs stored in PAGGGM. Our data indicate that despite better metabolic preservation, PAGGGM is not a suitable alternative for SAGM because storage in PAGGGM did not result in an increased PTR. Finally, RBCs recovered from circulation after transfusion showed reversal of the metabolic storage lesion in vivo within a day.
AB - 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 vs SAGM (saline-adenine-glucose-mannitol), on posttransfusion recovery (PTR) and metabolic restoration after transfusion was assessed. Subjects received an autologous biotinylated RBC concentrate stored for 35 days in SAGM or PAGGGM. As a reference for the PTR, a 2-day 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 the 2-day stored RBCs than in 35-day stored RBCs 2 and 7 days after transfusion: 96% (90 to 99) vs 72% (66 to 89) and 96% (90 to 99) vs 72% (66 to 89), respectively. PTR of SAGM- and PAGGGM-stored RBCs did not differ significantly. Glucose and redox metabolism were better preserved in PAGGGM-stored RBCs. The differences measured in the blood bag remained present only until 1 day after transfusion. No differences in RBC phenotype were found besides an increased complement C3 deposition on 35-day RBCs stored in PAGGGM. Our data indicate that despite better metabolic preservation, PAGGGM is not a suitable alternative for SAGM because storage in PAGGGM did not result in an increased PTR. Finally, RBCs recovered from circulation after transfusion showed reversal of the metabolic storage lesion in vivo within a day.
UR - http://www.scopus.com/inward/record.url?scp=85134337054&partnerID=8YFLogxK
U2 - https://doi.org/10.1182/bloodadvances.2022006987
DO - https://doi.org/10.1182/bloodadvances.2022006987
M3 - Article
C2 - 35477178
SN - 2473-9529
VL - 6
SP - 3899
EP - 3910
JO - Blood advances
JF - Blood advances
IS - 13
ER -