Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Department of Intensive Care Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
Blood Adv. 2022 Jul 12;6(13):3899-3910. doi: 10.1182/bloodadvances.2022006987.
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. This study is registered in the Dutch trial register (NTR6492).
添加剂溶液用于限制红细胞（RBC）在储存过程中的变化。几项研究表明，使用碱性添加剂溶液 PAGGGM（磷酸盐-腺嘌呤-葡萄糖-鸟嘌呤-葡萄糖-甘露醇）可以更好地保存葡萄糖和氧化还原代谢。在这项针对 20 名健康志愿者的随机开放标签干预试验中，评估了储存、PAGGGM 与 SAGM（生理盐水-腺嘌呤-葡萄糖-甘露醇）对输血后恢复（PTR）和输血后代谢恢复的影响。受试者接受了在 SAGM 或 PAGGGM 中储存 35 天的自体生物素化 RBC 浓缩液。作为 PTR 的参考，同时输注了在 SAGM 中储存 2 天的自体生物素化 RBC 浓缩液。输血后评估 RBC 表型和 PTR。输血后 24 小时内从循环中分离生物素化 RBC 进行代谢组学分析。输血后 2 天和 7 天，与 35 天储存的 RBC 相比，2 天储存的 RBC 的 PTR 显著更高：96%（90 至 99）与 72%（66 至 89）和 96%（90 至 99）与 72%（66 至 89）。SAGM 和 PAGGGM 储存的 RBC 的 PTR 没有显著差异。PAGGGM 储存的 RBC 中葡萄糖和氧化还原代谢得到更好的保存。在输血后 1 天之前，在血袋中测量到的差异仍然存在。除了在 PAGGGM 中储存 35 天的 RBC 上补体 C3 沉积增加外，未发现 RBC 表型的差异。尽管代谢保存更好，但 PAGGGM 不是 SAGM 的合适替代品，因为在 PAGGGM 中储存不会导致 PTR 增加。最后，输血后从循环中回收的 RBC 在体内一天内逆转了代谢储存损伤。本研究在荷兰试验注册处（NTR6492）注册。
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