Our previous studies have shown that the use of half-strength citrate anticoagulant improves plasma factor VIII stability while maintaining the viability of red cells and platelets. This study extends these observations to show that the stability of factor VIII is maintained in blood stored at room temperature or 4°C overnight and that in vitro tests indicate comparable quality of red cells and platelets prepared from half-strength citrate donations processed immediately or after overnight storage at room temperature. The exception to this was a more rapid loss of red cell 2,3-diphosphoglycerate, as has previously been observed for full-strength citrate donations.

To determine the viability of blood cells collected in half-strength (0.5 CPD.A2) and full-strength citrate anticoagulants, paired crossover autologous survival studies were performed in normal volunteers using 51Cr-labelled red cells after 35 days storage and 111In-labelled platelets after 5 days storage. For both studies, viability was better maintained in 0.5 CPD.A2 anticoagulant. This was significant for red cells (24-hour survival: 80 ± 6 vs. 52 ±21%) but not for platelets by either linear or multiple-hit models (recovery 51 ± 13 vs. 38 ± 14%, survival 5.1 ± 1.4 vs. 3.7 ± 1.5 days). The poor viability of red cells after storage in full-strength anticoagulant was associated with low cellular adenosine triphosphate levels and was confirmed in follow-up studies.