Storage of whole blood before separation: the effect of temperature on redcell 2,3 DPG and the accumulation of lactate

BACKGROUND: Although whole blood intended for component preparation is comm only left to cool at ambient temperature, knowledge is insufficient as to t he effects this may have on red cell quality, in particular after a prolong ed hold. STUDY DESIGN AND METHODS:Whole blood collected in ACD-A (7% wt/wt) and CPD (12% wt/wt) was incubated at 4, 10, 15, 20, 25, and 30 degrees C for 24 hou rs. Blood gases, pH, bicarbonate, glucose, lactate, and red cell 2,3 DPG we re investigated. RESULTS: When the blood was stored at 30 degrees C, the 2,3 DPG concentrati on decreased within 4 hours from 858 +/- 106 to 316 +/- 172 mmol per mol of hemoglobin (a 63% decrease); 99 percent was lost within 18 hours. At 25 de grees C, 46 percent was lost within 4 hours and 94 percent within 18 hours; at 20 degrees C, the decrease at 18 hours was 62 percent and that at 15 de grees C was 24 percent. No loss of 2,3 DPG was observed at 4 degrees C and 10 degrees C storage. No difference was attributable to the anticoagulant u sed. After 24 hours, the lactate concentration at 15 degrees C was 2.9 time s the original, that at 20 degrees C was 3.8 times the original, that at 25 degrees C was 7.0 times, and that at 30 degrees C was 9.2 times. CONCLUSIONS: With current anticoagulants, storage of whole blood at tempera tures of 25 to 30 degrees C before separation causes a great and rapid loss of 2,3 DPG and an accumulation of acid metabolites. In a hold of blood for >4 hours, rapid cooling is desirable to avoid initial loss of 2,3 DPG.