Studies on the mechanism of human red cell loss of viability during storage at +4 degrees C in vitro. III. Effects of mixing during storage.

Red cells supended in saline-adenine-glucose-mannitol solution were stored for 42 days at +4 degrees C. One portion was packed by centrifugation and stored unmixed; the other portion was mixed once a week. Red cell fluidity and adenine nucleotide concentration were significantly lower in unmixed than in mixed units and also differed within the packed layer, showing a decrease towards the bottom. Hemolysis was 2.5-fold and microvesiculation 5-fold higher in cells stored unmixed. It is suggested that, during liquid storage, an early accumulation of acid metabolites in the bottom part of packed red cells may play an important role both for adenylate loss and microvesiculation, but lack of membrane-stabilizing action of diethylhexylphthalate may in part explain the latter. Both of these two changes are factors associated with impaired red cell viability. Mixing appears essential to optimize storage conditions for red cells.