Whole blood storage in citrate and phosphate solutions containing half-strength trisodium citrate: cellular and biochemical studies.

The efficacy of whole blood preservation in acid citrate dextrose (ACD-A) and citrate-phosphate dextrose (CPD) anticoagulants containing half-strength trisodium citrate concentrations, was determined by biochemical and cellular assessment during 28 day storage at 4 degrees--6 degrees. Erythrocyte 2,3-DPG and ATP concentrations, serum potassium, plasma haemoglobin, and blood pH values were similar between the standard and half-strength citrate counterpart in both ACD-A and CPD series, throughout the entire storage period. Erythrocyte indices (MCV, MCH, MCHC, and osmotic fragility) and the red cell, platelet, and leucocyte counts, were also similar regardless of the final citrate concentration in both ACD-A and CPD series during the 28 day storage period. Tests of coagulation (PT, KCCT, TT, and ethanol gel) and fibrinogen levels were also similar, except for a lower quantity of clottable fibrinogen at day 28 in half-strength CPD. The formation of platelet and leucocyte aggregates during storage, as measured by changes in the SFP, were similar in magnitude whether or not the half-strength citrate formulation was used in ACD-A or CPD. Phagocytic and bactericidal capacity against Staph. aureus was normal following 24-hr storage at 4 degrees--6 degrees, in both ACD-A and CPD preserved blood, regardless of the final citrate concentration. It may now be concluded from this evaluation and those of others, that a reasonable argument can be made for reducing the citrate quantity presently used during blood storage, in order to provide a safe and effective transfusion product for routine use.