DIMENSIONAL, OSMOTIC, AND CHEMICAL CHANGES OF ERYTHROCYTES IN STORED BLOOD. I. BLOOD PRESERVED IN SODIUM CITRATE, NEUTRAL, AND ACID CITRATE-GLUCOSE (ACD) MIXTURES 1

Abstract

Dimensional, osmotic, and chemical changes of blood stored in (1) simple citrate soln., (2) a neutral, and (3) an acid, citrate-glucose (ACD) soln. were studied. During storage, red cells undergo changes in their dimensions; their thickness increases, their diam. decreases, and their apparent surface area is reduced. These alterations are interpreted as manifestations of progressive deterioration of the cell. They progress most rapidly in blood in simple citrate, and most slowly in blood in acid citrate-glucose soln. Changes in the corpuscular volume appear to be detd. by physico-chemical relationships and not to be related to the functional state of the cell. Osmotic hemolysis of erythrocytes becomes similarly altered in a progressive manner during storage, at a rapid rate in simple citrate and most slowly in acid citrate-glucose soln. The plasma pH decreases to a value of 7.1 in simple citrate soln., and to a value below 6.6 in the glucose-enriched media in direct relation to the amt. of lactic acid accumulated. The ability of the red cells to glycolyze is lost first in simple citrate soln. and is preserved longest in acid citrate-glucose soln. The inorganic P increases sharply in the red cells, with corresponding decrease of the organic acid-soluble P, but changes in a more gradual manner in the plasma. Adenosine triphosphate is preserved considerably longer in blood in ACD soln. than in the 2 neutral media. Decreases of K and increases of Na in erythrocytes have been confirmed. During storage, the total cation content of erythrocytes decreases. This fact and the constancy of the corpuscular vol. of erythrocytes in ACD soln. during storage are interpreted as indicating loss of cations on the acid side of the iso-ionic point of Hb, in direct proportion to the dissociation of Hb as a cation, with the osmolarity of the cells remaining constant. Judged by various indices the state of erythrocytes of citrated blood after 8 days is approx. equivalent to their state in neutral citrate-glucose after 18 days and in ACD soln. after 33 days. ACD soln. is recommended for practical use.