Sanne de Bruin

144 Chapter 6 Abstract Additive solutions are used to limit changes that red blood cells (RBCs) undergo during storage. Several studies have shown better preservation of glucose and redox metabo- lism using the alkaline additive solution PAGGGM (phosphate-adenine-glucose-guano- sine-gluconate-mannitol). In this randomized open label intervention trial in 20 healthy volunteers, the effect of storage in PAGGGM on post transfusion recovery (PTR) and metabolic restoration after transfusion was assessed. Subjects received either an autologous RBC concentrate stored for 35 days in SAGM or in PAGGGM. As a reference for the PTR, a 2-days stored autologous biotinylated RBC concentrate stored in SAGM was simultaneously transfused. RBC phenotype and PTR were assessed after transfusion. Biotinylated RBCs were isolated from the circulation for metabolomics analysis up to 24 hours after transfusion. The PTR was significantly higher in 2 days stored RBCs than in 35 days stored RBCs after 2 and 7 days after transfusion: 96% [90-99] versus 72% [66-89] and 96% [90-99] versus 72% [66-89] respectively. PTR of SAGM and PAGGGM stored RBCs did not differ signifi- cantly. Glucose and redox metabolism were better preserved in PAGGGM stored RBCs. This difference was still present directly after transfusion but disappeared within one day after transfusion. No differences in RBC phenotype were found besides an increased complement C3 deposition on 35 days RBCs stored in PAGGGM. Our data indicate that despite better metabolic preservation, storage in PAGGGM did not result in an increased PTR. Finally, RBC that were recovered from circulation after transfusion showed reversal of the metabolic storage lesion in vivo .