Specific Agglutinability of Erythrocytes from Whole Blood Stored at 4 C

When whole blood is supplemented with adenine, the erythrocytes are suitable for transfusion after at least 35 days of storage at 4C, but information is not available as to whether such cells remain satisfactory for blood typing and pre transfusion tests for evidence of incompatibility. Accordingly, we designed experiments to evaluate by AutoAnalyzer the specific agglutinability of erythrocytes obtained from whole blood stored at 4C. Seven normal volunteer donors of both sexes, aged between 22 and 31 years, were chosen and bled periodically so that, over a three-day testing period, all blood specimens from each donor could be evaluated. Each donor provided at each bleeding sufficient blood to permit aliquots of 20 ml to be stored as clotted blood and 8 ml to be stored as citrated whole blood. Four kinds of citrate solution were used: ACD Formula A, CPD, ACD supplemented with adenine, and CPD supplemented with adenine. All clotted specimens were tested after 0, 1, 2, 3, 4, and 5 weeks of storage, while all citrated specimens were tested after 0, 1, 2, 3, 4, 5, 6, 8, and 10 weeks of storage. Six blood group systems were used for evaluation with the following reagents: anti-A or anti-B, anti-Rhl (Rh_o or D), anti-K2 (k or Cellano), anti-Jk^a, anti-Fy^a or anti-Fy^b, and anti-M. Each reagent was used at a dilution to support from 20 to 80 per cent agglutination with freshly drawn blood, and each reagent was tested under two conditions: low ionic and normal ionic. The results disclosed loss of specific agglutinability in association with the time of storage of whole blood at 4 C. The onset and degree of loss depended both on the kind of test used (normal ionic tests showed loss 2.8 weeks earlier than did low ionic tests) and the condition in which the blood was stored (loss occurred sooner and then progressed more with clotted blood than with citrated blood). Average losses of 25, 50, and 75 per cent were observed at 1.1, 2.1, and 4.0 weeks of storage for normal ionic tests of clotted blood, and at 4.1, 6.0, and 7.6 weeks for similar tests of citrated blood. Loss of specific agglutinability during storage was significantly less for the red blood cells of some donors than for others, but systematic differences between specific blood-typing tests were not observed. ACD and CPD solutions behaved similarly, while adenine supplementation exerted a slight preservative effect after 6, 8, and 10 weeks of storage. Loss of specific hemagglutinability of stored cells was not due to loss of specific antigenic sites because stored cells were as effective as fresh cells for the absorption of anti-B, anti-Rhl, and anti-M. Loss might, however, be related to an increase in the accumulation of IgG, fibrinogen, and albumin at the surfaces of erythrocytes.