Abstract
Prolongation of the viability of red cells in vitro has been the goal of many investigations. Freezing of red cells is theoretically a good solution; it is not as yet practical except under special conditions. Addition of nucleotides, as supplied by adenine (1) and, preferably, of adenine and a nucleoside, inosine (2-4), has achieved considerable success. However, while searching for longevity, study of the function of stored cells has been neglected. Valtis and Kennedy reported (5) that the affinity of hemoglobin for oxygen increases with storage of blood in acid-citrate-dextrose (ACD) solution in the cold. With this increased affinity, oxygen release to tissue is decreased; several hours are required for partial restoration of normal oxygen release. Such delay may have serious consequences in the case of acute blood loss. In 1967, Benesh and Benesh (6) and Chanutin and Curnish (7) found that certain phosphorylated compounds, particularly adenosine triphosphate (ATP) and 2, 3-diphosphoglycerate (2,3-DPG) control the oxygen affinity of hemoglobin; ATP and 2, 3-DPG appear to have a similar effect on a molar basis (8).
Adenine added to ACD blood, while increasing the useful period of storage to 35 days, was found to increase the oxygen-hemoglobin affinity (9); incubation of stored ACD blood with inosine at 37—° was found to restore partially ATP, 2,3-DPG, and oxygen dissociation (8, 9). Bunn et al. (9) state that when inosine was added to ACD-adenine blood at the time of collection, oxygen affinity increased much more slowly; addition of inosine at 20 days of storage and incubation at 37°, showed improvement of the level of 2,3-DGP and ATP, with decreased oxygen affinity. Valeri and Hirsh (10) found that the ATP of stored ACD cells increases rapidly after transfusion, but 2, 3-DPG increases more slowly, being above the 50% level at 24 hr postransfusion and requiring 11 days to reach the maximal level.
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