Value of Adenine, Various Nucleosides, and Ouabain in Maintenance of Integrity of Red Blood Cells Under Blood Bank Conditions

The effects of adenine and various nucleosides on adenine nucleotide metabolism in red cells, as well as on other factors related to the storability of blood were compared during six weeks of storage under blood bank conditions. Adenosine triphosphate (ATP) and total adenine nucleotides were maintained at higher levels, and higher ratios of ATP to adenine diphosphate were observed, in blood containing citrate-phosphate-dextrose (CPD) solution than in blood containing acid-citrate-dextrose (ACD) solution. Higher levels of ATP and total adenine nucleotides were maintained in blood containing ACD together with both adenine and inosine than in blood containing ACD alone or together with only one of the two purines. ACD-adenine was more effective in maintaining adenine nucleotides than was ACD-inosine. Addition of uridine did not have any effect on adenine nucleotides in red cells. ATP and total adenine nucleotides were maintained at higher levels in CPD-adenine than in CPD alone. The effect of CPD-inosine or CPD-adenine-inosine was not investigated. ACD-inosine caused a marked increase in plasma lactate, and inhibited glucose utilization, during storage. An increase in plasma inorganic phosphate was delayed by the addition of inosine, and this effect was augmented by adenine and guanosine. There were no findings suggestive of a beneficial effect of these additives on active cation transport, osmotic fragility,hemolysis, or the deterioration of blood cell morphology. Ouabain, an inhibitor of ATPase, had little effect on red cell nucleotide patterns or on other biochemical or morphological criteria for blood storage, possibly because of the low activity of ATPase at 4°C.