Abstract
Experiments were undertaken to determine whether the effects recently reported by Unger 1 to result from the action of sodium citrate on the blood when added in the proportions used in transfusion might not be related in some way to the hydrogen-ion concentration of the solution used. These effects, as given by Unger, included the formation of a substance derived from the stroma of the red cells which is anticomplementary in the Wassermann reaction, the red cells being at the same time rendered more fragile, together with a direct interference with the action of complement, a practical destruction of the phagocytic activity of the leucocytes, and a reduction in the effect of opsonin.
Three sodium citrate solutions (2 per cent.) having PH values of 4.1, 7.25 and 9.56 were added to blood in ratios of 1:2 and 1 : 9. With but an occasional exception the citrated plasmas thus obtained showed no anticomplementary power. With both whole blood and plasma a varying amount of precipitate usually appeared, which increased on inactivation. It was not present in citrated serum. The citrated extracts of washed red cells were not anticomplementary. Repeated tests of the citrated blood for red-cell fragility were negative, as indeed were the phagocytic indices of leucocytes exposed to citrate. In the main our results were diametrically opposite to those reported, regardless of the PH of the solution used. These results indicate that the reactions attending the use of citrate must be sought by other criteria. They may be associated with the disturbance of equilibrium causing the precipitate above mentioned.
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