Byron A. Myhre

Effects of AS-3 nutrient-additive solution on 42 and 49 days of storage of red cells.

Storage of red blood cells in a nutrient‐additive solution, AS‐3 (Nutricel, Cutter Biological, Berkeley, CA), was evaluated after 42 and 49 days of storage by in vitro measurements of hemolysis, adenosine triphosphate (ATP) levels, glucose levels and other constituents, and in vivo study of 24‐hour survival of autologous, reinfused red cells labeled with 51Cr with and without 125I human serum albumin. Two laboratories conducted the studies independently. After 42 days of storage, hemolysis was within an acceptable range (0.72 +/− 0.4% and 1 +/− 0.2%), ATP decreased to 61 percent and 56 percent in the two laboratories, and 24‐hour survivals were 85.1 +/− 8.3 percent for single‐label cells in one laboratory and 82.8 +/− 10 percent (single‐ label cells) and 84.1 +/− 13.1 percent (double‐label cells) in the second laboratory. Thus, results for single‐ and double‐label cells were similar. After 49 days of storage, ATP fell to 45 and 46 percent in the two laboratories. Twenty‐four‐hour recovery fell to 69.4 +/− 7.4 percent with single‐label cells and to 68.2 +/− 6.7 percent with double‐ label cells in one laboratory. In the other laboratory, a paired study comparing AS‐3 with the already approved AS‐1 solution (Adsol; Fenwal Laboratories, Deerfield, IL) showed nearly identical 24‐hour survivals of 71.9 +/− 8.8 percent in Nutricel and 71.8 +/− 6.5 percent in Adsol. These studies demonstrate the excellent viability of the new solution after 42 days of study. At 49 days of study, viability decreased significantly and was comparable in the two nutrient‐additive solutions studied. The value of paired comparison study is demonstrated by the latter results.

Survival of Red Cells Stored for 21 and 35 Days in a Non‐Di‐(2‐Ethylhexyl)Phthalate Plastic Container

Abstract. Whole blood and red cells were stored using citrate‐phosphate‐dextrose (CPD) and citrate‐phosphate‐dextrose‐adenine (CPDA‐1) anticoagulants in polyvinylchloride bags made flexible with di‐(2‐ethylhexyl)phthalate (DEHP) or tri‐(2‐ethylhexyl)trimellitate (TOTM) plasticizers. After storage the posttransfusion viability of these cells was tested in autologous donors. Cells stored in TOTM‐plasticized film had a survival rate less than 75% when stored for 35 days, while other systems had a survival greater than this. When compared with the red cells stored in CPD‐DEHP‐plasticized film, the viability of whole blood and red cells stored in CPDA‐TOTM showed a statistically significant decrease (p = <0.01). Therefore, red cell storage in TOTM‐plasticized PVC with current anticoagulant should be limited to 21 days.

Chemical Analysis of a 30‐Year‐Old Bottle of Lyophilized Plasma

The biochemical constituents of a 30‐year‐old sealed bottle of lyophilized plasma were analyzed. The results in this communication show that the process of lyophilization and storage has not seemed to cause any great changes in plasma components, including hormones, enzymes, and proteins.

A rapid method for determining the sterility of frozen-reconstituted blood

A rapid, fast, and accurate method of determining bacterial contamination in blood units is needed to provide a safe unit of frozen‐ reconstituted blood which can be stored at 4 C after thawing for more than the 24 hours currently allowed by law. The Bactec instrument seems to provide this method. It detects most of the organisms which have been reported in contamineted blood, and does this in a short enough period of time that any organisms introduced into the blood unit during the sampling process will not grow sufficiently to contaminate the unit while the culturing process is going on.

The Computer in the Blood Bank

This article will review the historical use of the computer in the blood bank and will show some examples of its current use today. A discussion will be included of the major areas in the blood bank where a computer would be particularly valuable and also of areas where it would be contraindicated. A few examples of the use in various institutions will be cited. Discussion of telecommunications as a possible method of inventory leveling and inventory control between blood banks will be included.

Studies on 4 C stored frozen-reconstituted red blood cells. III. Changes occurring in units which have been repeatedly frozen and thawed.

Units of frozen red blood cells were thawed, stored at 4 C for varying amounts of time up to five days, and then subsequently refrozen. This procedure was repeated for two or three cycles. Chemical and cytological studies showed that only a moderate number of red blood cells were lost and that the red blood cells would be transfusable with minimal danger to the patient. The units retained their sterility despite all of the manipulations. The ability to refreeze a unit of blood would extend the value of frozen blood greatly by preventing the loss of very rare units.

Studies on 4 C Stored Frozen-Reconstituted Red Blood Cells: I. Bacterial Growth

A knowledge of the growth rates of various organisms at the storage temperature of 4 C in the different suspending media used for red blood cells would aid the extension of the thawed storage time of frozen‐reconstituted blood beyond the 24 hours allowed by the Food and Drug Administration. Knowing these rates, a prediction could be made that the growth rate would be sufficiently slow and the unit (sterile or minimally contaminated) could be given safely after a longer storage period. The studies reported show that the pathogenic organisms S. aureus, Ps. aeruginosa, E. coli, Klebsiella sp. and Enterobacter sp. grow at such a slow rate at 4 C that they do not represent any great hazard to the recipient unless introduced in great numbers. The studies further show that in the process of washing frozen blood the number of organisms is reduced by between one and two orders of magnitude (base 10). Therefore, extension of frozen red blood cell storage life to at least 72 hours should be considered.

Human tetanus immune globulin as a cause of a positive antiglobulin test.

To the Editor: Our laboratory has developed a low ionic strength procedure for the preparation of red blood cells coated with C3b in the absence of detectable C4 or immunoglobulins. Starting in July, 1977, all manufacturers of anti-human serum claiming anti-C3b activity have been required by the Bureau of Biologics (BOB) to use this procedure to substantiate their claims. We have been requested by the BOB to make the method generally available at this time since this procedure is used to produce reference preparations. It should prove useful in quality control and evaluation of anti-human serums.

Unnecessary Albumin Therapy in a Jaundiced Patient

A 40 year‐old woman with obstructive jaundice due to carcinoma of the head of the pancreas is presented. Chemical determinations on the patients jaundiced serum, using an organic dye‐binding method showed a low albumin determination which led to infusion of six units of salt poor albumin. Subsequent studies of albumin by electrophoresis using the pretransfusion specimen showed a normal quantity of albumin. Caution is urged in the transfusion of albumin to jaundiced patients, since the dye‐binding technique is in common use in the automated chemistry panel.