Читать книгу Transfusion Medicine - Jeffrey McCullough - Страница 126

The beginning of red cell preservation can be traced to Peyton Rous, who was later awarded the Nobel Prize for his work with viruses. Rous [14] and Turner showed that glucose delayed in vitro hemolysis. During the period between World Wars I and II, Mollison [15] in England developed an acidified citrate and glucose solution for red cell preservation, variants of which are the mainstay of present‐day preservatives. These solutions are composed of citrate for anticoagulation, dextrose for cell maintenance, and phosphate buffers (Table 5.4). WB or RBCs can be stored in these solutions for periods ranging from 21 to 35 days.

During red cell preservation, adenosine triphosphate (ATP) loss generally correlates with poor red cell viability, and addition of adenine at the beginning of preservation increases ATP and improves red cell viability [16]. 2,3‐Diphosphoglycerate (2,3‐DPG) also declines in stored red cells, and this is associated with increased affinity of hemoglobin for oxygen [17–19]. Thus, there was considerable interest in developing solutions that would maintain both ATP and 2,3‐DPG while allowing removal of the maximum volume of plasma for production of derivatives. It is possible to extend the duration of red cell storage by placing the red cells in special “additive” solutions containing various combinations of saline, adenine, phosphate, bicarbonate, glucose, and mannitol [20–23] (Table 5.5). These solutions provide better nutrients that maintain red cell viability, red cell enzymes, and red cell function, allowing red cell preservation for 42 days (Table 5.6).