Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden.
Vox Sang. 2022 Feb;117(2):193-200. doi: 10.1111/vox.13177. Epub 2021 Jul 15.
Due to increasing concerns about possible endocrine-disrupting properties, the use of the plasticizer di(2-ethylhexyl) phthalate (DEHP) will be banned in future blood storage. Di(2-ethylhexyl) terephthalate (DEHT) provides sufficient red blood cell (RBC) quality during conventional blood bank storage. It is important that a new plasticizer also maintains acceptable quality during exposure to high cell stress, such as irradiation, which is commonly used to prevent graft-versus-host disease.
A total of 59 RBC units were collected and processed in polyvinyl chloride (PVC)-DEHT or PVC-DEHP blood bags combined with either saline-adenine-glucose-mannitol (SAGM) or phosphate-adenine-glucose-guanosine-saline-mannitol (PAGGSM) additive solution. All units were X-ray irradiated on day 2 post-collection. Sampling for assessment of parameters of storage lesion was performed on day 2 pre-irradiation and day 14 and 28 post-irradiation.
Though irradiation increased cell stress, DEHT/PAGGSM and current common European preference DEHP/SAGM were equally affected up to 14 days post-irradiation for all measured parameters. At day 28, haemolysis and microvesicle count were slightly increased in DEHT, whereas extracellular potassium ions, glucose, lactate, pH, mean corpuscular volume and microvesicle phosphatidylserine remained unaffected by plasticizer choice throughout storage. No individual unit exceeded 0.8% haemolysis, not even in DEHT/SAGM, the combination overall most affected by irradiation. Of the four combinations, membrane stability was least impacted in DEHP/PAGGSM.
We demonstrate that DEHT is a suitable plasticizer for storage of RBCs after X-ray irradiation cell stress. This strengthens the option of DEHT as a viable non-phthalate substitute for DEHP.
由于人们越来越关注塑料增塑剂邻苯二甲酸二（2-乙基己基）酯（DEHP）可能具有内分泌干扰特性，未来的血液储存将禁止使用 DEHP。邻苯二甲酸二（2-乙基己基）酯（DEHT）在常规血库储存期间可提供足够的红细胞（RBC）质量。重要的是，一种新的增塑剂在暴露于高细胞应激（如辐照）时也能保持可接受的质量，辐照常用于预防移植物抗宿主病。
共采集并处理了 59 个 RBC 单位，分别置于聚氯乙烯（PVC）-DEHT 或 PVC-DEHP 血袋中，并用生理盐水-腺嘌呤-葡萄糖-甘露醇（SAGM）或磷酸盐-腺嘌呤-葡萄糖-鸟嘌呤-生理盐水-甘露醇（PAGGSM）添加剂溶液处理。所有单位均在采集后第 2 天进行 X 射线辐照。在辐照前第 2 天、辐照后第 14 天和第 28 天采集样本，评估储存损伤的参数。
尽管辐照增加了细胞应激，但 DEHT/PAGGSM 和当前欧洲常用的 DEHP/SAGM 对所有测量参数的影响在辐照后 14 天内是相同的。在第 28 天，DEHT 组的溶血和微囊泡计数略有增加，而细胞外钾离子、葡萄糖、乳酸、pH 值、平均红细胞体积和微囊泡磷脂酰丝氨酸在整个储存过程中不受增塑剂选择的影响。即使在 DEHT/SAGM 中，也没有单个单位的溶血超过 0.8%，而 DEHT/SAGM 是受辐照影响最大的组合。在这四种组合中，DEHP/PAGGSM 对膜稳定性的影响最小。
我们证明 DEHT 是辐照后储存 RBC 的合适增塑剂。这增强了 DEHT 作为 DEHP 可行的非邻苯二甲酸酯替代品的选择。
