Restoration in vivo of erythrocyte adenosine triphosphate, 2,3-diphosphoglycerate, potassium ion, and sodium ion concentrations following the transfusion of acid-citrate-dextrose-stored human red blood cells.

Abstract

Abstract With the use of a manual differential agglutination procedure to recover liquid-preserved group O red cells after transfusion to group A 1 recipients, changes in intracellular levels of 2,3-DPG, ATP, sodium ion, and potassium ion were studied. A significant increase in cellular 2,3-DPG occurred immediately at the completion of the 234 hour transfusions. Within 3 hours following transfusion the level of 2,3-DPG was at least 1.27 μmoles per 10 10 RBC, 1.12 μmoles per milliliter of RBC, 3.48 μmoles per gram of Hb, or 0.233 moles per mole of Hb. The level of 2,3-DPG was above 50 per cent of the final level within 24 hours after transfusion, and it then continued to increase gradually up to 11 days. The ATP level of the transfused red cells increased rapidly, a change that was associated with a rapid decrease of the donor cell sodium ion content during the 24 hour posttransfusion period. Donor cellular potassium ion concentration increased slowly; the rate of rise appeared to be related to the increasing level of intracellular 2,3-DPG. Other investigators have established a relation between the organic phosphates, ATP and 2,3-DPG, and oxyhemoglobin dissociation characteristics of preserved red cells. The methods used for red cell preservation ideally should maintain the levels of organic phosphates, so that the cells will have normal affinity for oxygen at the time of transfusion.