Pre-separation storage of whole blood: the effect of temperature on red cell 2,3-diphosphoglycerate and myeloperoxidase in plasma

Background: Although whole blood intended for component preparation is comm only left to cool at ambient temperature, knowledge is insufficient concern ing what effects this may have on red blood cell (RBC) quality, in particul ar after a prolonged hold. Study design and methods: Whole blood collected in CPD was incubated at 20 degrees C and 28 degrees C for 6 h designed as a paired study. Blood compon ents were prepared and the red blood cell concentrates (RBCs) were stored f or 28 days at 4 degrees C +/- 2 degrees C. Blood gases, pH, glucose, lactat e, adenosine triphosphate (ATP), 2,3-diphosphoglycerate (2,3-DPG) and plasm a myeloperoxidase (MPO) were investigated. Results: After 6 h the 2,3-DPG concentrations had lowered to 88% (20 degree s C) and 54% (28 degrees C) of initial levels, respectively. The difference was significant and was maintained for 28 days, although, at low levels fr om day 7 (28 degrees C) and day 14 (20 degrees C) of storage. ATP was maint ained at the initial level in both groups during the first 6 h of storage b ut after component separation the levers were significantly higher in the 2 8 degrees C group during the first 5 days. The release of myeloperoxidase ( MPO) was significantly higher in the non-cooled group than in the cooled gr oup. Conclusions: Pre-separation holding for 6 h of whole blood at temperatures of 28 degrees C causes a great and rapid loss of 2,3-DPG and considerable f ormation of acid metabolites resulting in clearly subnormal 2,3-DPG levels even on day 1. Active pre-separation cooling to 20 degrees C is to be recom mended. (C) 1999 Elsevier Science Ltd. All rights reserved.