An investigation of red blood cell concentrate quality during storage in paediatric‐sized polyvinylchloride bags plasticized with alternatives to di‐2‐ethylhexyl phthalate (DEHP)

Abstract

The results suggest that the BTHC formulation used was detrimental to RBC quality. DINCH bags could be a viable alternative to DEHP: they outperformed DEHP bags energetically, with better maintenance of ATP levels.

In vitro evaluation of di(2‐ethylhexyl)terephthalate–plasticized polyvinyl chloride blood bags for red blood cell storage in AS‐1 and PAGGSM additive solutions

“…Given the data presented in this study as well as reports from other non–DEHP‐plasticized blood bag evaluations, the absence of DEHP has a negative impact on hemolysis using traditional ASs . The choice of AS can be very beneficial for the hemolysis results of non‐DEHP blood bags.…”

“…Other higher cost alternatives such as butyryl trihexyl citrate and tris(2‐ethylhexyl)trimellitate have been used selectively in blood bag systems. The newest non‐DEHP alternative, DINCH can be more expensive than DEHP and has been the subject of several studies . DEHT on the other hand is a well‐regarded, cost‐effective nonphthalate with excellent safety profile …”

The Blood Bag Plasticizer Di-2-Ethylhexylphthalate Causes Red Blood Cells to Form Stomatocytes, Possibly by Inducing Lipid Flip-Flop

“…The DEHP is known to have a beneficial effect on RBCs that are stored for transfusion, reducing susceptibility to hemolysis [8,9,10,29] and minimizing the formation of both echinocytes [10] and microparticles [8,9,10,11]. Hemolysis, vesicle formation, and the shape changes associated with echinocyte formation are associated with the membrane; together with the known association of DEHP with the RBC membrane [3], this makes the DEHP-membrane interactions a specific target to study.…”

“…Storage materials with alternative plasticizers have been investigated for RCCs, due to the potential health effects of DEHP [8,9,10,11,12]. One challenge associated with the replacement of DEHP is that it has beneficial effects on the RBCs, extending the shelf life of the stored RCCs [8,9,10].…”

Closing in on DEHP‐free red blood cell concentrate containers

“…On the other hand, DINCH has very similar structural and technical properties as DEHP without the negative toxicity effects . DINCH has been shown to be a better alternative than BTHC plasticizer because it retains the same RBC membrane–stabilizing effects as DEHP and can maintain RBC quality for up to 42 days of storage . Therefore, although DINCH is more expensive than DEHP, due to its favorable toxicity profile, it is considered as one of the most promising alternative plasticizers to DEHP …”