Rejuvenation of irradiated AS‐1 red cells

BACKGROUND: Gamma irradiation of blood components is used to prevent transfusion‐associated graft‐versus‐host disease. The demand for irradiated blood components is increasing because of the increase in directed donation by family members. Irradiated units currently have a recommended maximum storage life of 28 days. Since in vivo recovery is related to red cell ATP levels, rejuvenation of stored irradiated units using a pyruvate‐inosine phosphate‐adenine additive was explored.STUDY DESIGN AND METHODS: Units of AS‐1 red cells from 16 volunteer donors were divided into two equal volumes and one split unit from each was irradiated with 25 Gy. Ten units were irradiated on Day 5, 6, or 7 of 4°C storage and 6 units were irradiated on Day 1 of 4°C storage. All units were rejuvenated for 1 hour at 37°C using a pyruvate‐inosine‐phosphate‐adenine additive on Day 42 of 4°C storage. Units were assayed for ATP, 2, 3 DPG and supernatant sodium, potassium, and glucose.RESULTS: ATP and 2, 3 DPG levels were restored equally well in irradiated and non‐irradiated units. The previously reported irradiation‐induced red cell potassium‐sodium shift was demonstrated. Supernatant potassium and sodium levels did not reverse 1 hour after rejuvenation was completed. There was no significant difference in results between units irradiated on Day 1 or Day 5, 6, or 7.CONCLUSION: Red cell ATP and 2, 3 DPG levels were restored in irradiated AS‐1 units stored at 4°C for 42 days using a pyruvate‐inosine‐phosphate‐adenine rejuvenation additive.