Attenuation of the Red Blood Cell Storage Lesion to Allow Extended use of Previously Cryopreserved (pRBC) Units in Austere Environments

Transfusion of blood is optimal treatment for blood loss. Resuscitation strategies emphasize transfusion of packed red blood cells (pRBCs) and fresh frozen plasma in equal ratios with minimal use of crystalloid fluids. The need for readily available pRBCs poses significant challenges for inventory/management/distribution. An additional issue is that pRBCs will degrade during storage. Our study examined strategies to attenuate progression of the red blood cell storage lesions in previously cryopreserved pRBCs. We hypothesized that post-thaw treatments of previously cryopreserved pRBCs would inhibit components of storage lesion. Methods: We examined three strategies to potentially attenuate the accelerated storage lesion after previous cryopreservation. First, experiments evaluated effect of post-thaw pH buffering on storage lesion development. Next, experiments treated post-thaw pRBCs with amitriptyline. The third set of experiments included testing AS-7 as an alternative to AS-3 after cryopreservation, thawing, and deglycerolization. Conclusion: The red blood cell storage lesion is more severe following cryopreservation. The storage lesion is exacerbated in an acidic environment. Post-deglycerolization storage in AS-3 with the addition of amitriptyline may attenuate aspects of the storage lesion. Storage of previously cryopreserved pRBCs inAS-7 may decrease some aspects of the storage lesion.