Effects of a plasticizer leached from polyvinyl chloride on the subhuman primate: a consequence of chronic transfusion therapy.

The effects of di-2-ethylhexyl phthalate (DEHP) on hepatic function and histology were evaluated in the rhesus monkey undergoing chronic transfusion. DEHP was solubilized as a result of leaching by platelets or plasma stored in polyvinyl chloride (PVC) blood bags. The average cumulative amount of DEHP infused in 1 year was 69.3 mg., or 21.3 mg./kg. Comparable amounts of DEHP are received by patients who undergo chronic transfusions with whole blood, packed cells, platelets, and plasma in the same time period. Four of the seven PVC-transfused monkeys had abnormal 99mTc liver-spleen scan ratios, four of the seven demonstrated abnormal BSP clearance, and six of the seven had abnormal liver histopathology upon completion of transfusion therapy. These findings persisted in a majority of the monkeys throughout the follow-up period. DEHP persisted in the tissues for up to 14 months after transfusion. The nontransfused monkeys and those transfused with platelets processed in polyethylene containers were normal.