Evaluation of the in vitro quality of X‐ray irradiated red cell concentrates processed and stored using di(2‐ethylhexyl) terephthalate plasticized blood bag sets
- 1NetCAD Canadian Blood Services Edmonton Alberta Canada
- 2NetCAD Canadian Blood Services Vancouver British Columbia Canada
Abstract
Background and Objectives: Polyvinyl chloride (PVC) blood bags plasticized with di(2‐ethylhexyl) phthalate (DEHP) have long been the standard for red blood cell (RBC) storage. Due to safety concerns, alternatives like di(2‐ethylhexyl) terephthalate (DEHT), in combination with next‐generation additive solutions like phosphate‐adenine‐glucose‐guanosine‐saline‐mannitol (PAGGSM), are being explored. While these show promise in maintaining RBC quality during storage, irradiated RBCs remain underexplored. This study compared the in vitro quality of irradiated red cell concentrates (RCCs) stored in DEHT/PAGGSM and DEHP/saline‐adenine‐glucose‐mannitol (SAGM) blood bag systems to support the transition to DEHP‐free storage systems.
Materials and Methods: Whole blood (WB) was collected into citrate‐phosphate‐dextrose anticoagulant using either 500 mL DEHP/SAGM or 475 mL DEHT/PAGGSM blood bag systems (n = 10 per group). Leukoreduced RCCs were prepared within 24 h using a top/bottom, red cell filtered processing method. RCCs were X‐ray irradiated on day (d) 14 with haematological, membrane, metabolic and biomechanical parameters measured on d8 and d15 post‐irradiation (post‐IRR).
Results: Irradiated (IRR) DEHT/PAGGSM RCCs exhibited significantly higher haemolysis than IRR‐DEHP/SAGM units both pre‐irradiation (pre‐IRR) and on d8 and d15 post‐IRR (p < 0.001), although levels remained below 0.8%. On d8 and d15 post‐IRR, glucose concentrations were lower in IRR‐DEHT/PAGGSM units (p < 0.001), while potassium, lactate and adenosine triphosphate (ATP) levels remained comparable between groups, both with p > 0.05. IRR‐DEHT/PAGGSM RBCs displayed reduced elongation, higher membrane rigidity (p < 0.05) and lower O min, O max, O hyper and delta O on d8 and d15 post‐IRR, all with p < 0.001.
Conclusion: DEHT/PAGGSM is a viable DEHP‐free alternative for X‐ray irradiated RBC storage, maintaining acceptable in vitro quality up to d14 pre‐IRR and d15 post‐IRR.
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BibTeX
@article{olafson2026evaluation,
title = {{Evaluation of the in vitro quality of X‐ray irradiated red cell concentrates processed and stored using di(2‐ethylhexyl) terephthalate plasticized blood bag sets}},
author = {Carly Olafson and Sanaz Hemmatibardehshahi and Geraldine M. Walsh and Anita Howell},
journal = {Vox Sanguinis},
year = {2026},
month = jul,
doi = {10.1111/vox.70328},
url = {https://doi.org/10.1111/vox.70328},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Evaluation of the in vitro quality of X‐ray irradiated red cell concentrates processed and stored using di(2‐ethylhexyl) terephthalate plasticized blood bag sets
AU - Carly Olafson
AU - Sanaz Hemmatibardehshahi
AU - Geraldine M. Walsh
AU - Anita Howell
PY - 2026
DA - 2026/07/19
JO - Vox Sanguinis
DO - 10.1111/vox.70328
UR - https://doi.org/10.1111/vox.70328
AB - Background and Objectives: Polyvinyl chloride (PVC) blood bags plasticized with di(2‐ethylhexyl) phthalate (DEHP) have long been the standard for red blood cell (RBC) storage. Due to safety concerns, alternatives like di(2‐ethylhexyl) terephthalate (DEHT), in combination with next‐generation additive solutions like phosphate‐adenine‐glucose‐guanosine‐saline‐mannitol (PAGGSM), are being explored. While these show promise in maintaining RBC quality during storage, irradiated RBCs remain underexplored. This study compared the in vitro quality of irradiated red cell concentrates (RCCs) stored in DEHT/PAGGSM and DEHP/saline‐adenine‐glucose‐mannitol (SAGM) blood bag systems to support the transition to DEHP‐free storage systems. Materials and Methods: Whole blood (WB) was collected into citrate‐phosphate‐dextrose anticoagulant using either 500 mL DEHP/SAGM or 475 mL DEHT/PAGGSM blood bag systems (n = 10 per group). Leukoreduced RCCs were prepared within 24 h using a top/bottom, red cell filtered processing method. RCCs were X‐ray irradiated on day (d) 14 with haematological, membrane, metabolic and biomechanical parameters measured on d8 and d15 post‐irradiation (post‐IRR). Results: Irradiated (IRR) DEHT/PAGGSM RCCs exhibited significantly higher haemolysis than IRR‐DEHP/SAGM units both pre‐irradiation (pre‐IRR) and on d8 and d15 post‐IRR (p < 0.001), although levels remained below 0.8%. On d8 and d15 post‐IRR, glucose concentrations were lower in IRR‐DEHT/PAGGSM units (p < 0.001), while potassium, lactate and adenosine triphosphate (ATP) levels remained comparable between groups, both with p > 0.05. IRR‐DEHT/PAGGSM RBCs displayed reduced elongation, higher membrane rigidity (p < 0.05) and lower O min, O max, O hyper and delta O on d8 and d15 post‐IRR, all with p < 0.001. Conclusion: DEHT/PAGGSM is a viable DEHP‐free alternative for X‐ray irradiated RBC storage, maintaining acceptable in vitro quality up to d14 pre‐IRR and d15 post‐IRR.
SN - 0042-9007
SN - 1423-0410
ER -