Advertisement
Research Article| Volume 9, ISSUE 3, P317-330, 1988

Effects of plasticizers on red blood cells and platelets during storage

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      The introduction of plastic bags into routine use in Blood Banks began a revolution in how human blood and blood components were prepared, stored and used.
      The plastic film is not inert, however, and plasticizers added to increase flexibility of the bags can be extracted into the stored components. In this report, the characteristics of this extraction, and the effect of exposure to the extracted material on the components in storage, is reviewed and discussed.
      Particular emphasis is placed on the organic compound, di(2-ethylhexyl) phthalate (DEHP), which can constitute up to 40% of the weight of classic PVC films. DEHP has been shown to interact both with erythrocytes, where the interaction aids in preservation of erythrocyte integrity, and with platelets, where the interaction has been shown to be deleterious to maintenance of platelet function.
      The advantages and disadvantages of plastics formulated without DEHP are also presented and evaluated.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Transfusion and Apheresis Science
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Gajewski HM
        The role of raw material selection and concentration on PVC compound performance.
        Technical Review (Fenwal). 1986;
        • Ozge A
        • Baldini M
        • Goldstein R
        Effect of plastic and glass surfaces on clot retraction and serotonin uptake of platelet-rich plasma stored at 4 °C.
        J Lab Clin Med. 1964; 63: 378-393
        • Guess WL
        • Jacob J
        • Autian J
        A study of polyvinyl chloride blood bag assemblies. I. Alteration or contamination of ACD solutions.
        Drug Intell. 1967; 1: 120-127
        • Marcel YL
        • Noel SP
        Contamination of blood stored in plastic packs.
        Lancet. 1970; 1: 35
        • Jaeger RJ
        • Rubin RJ
        Contamination of blood stored in plastic packs.
        Lancet. 1970; 2: 151
        • Jaeger RJ
        • Rubin RJ
        Plasticizers from plastic devices: extraction. metabolism, and accumulation by biological systems.
        Science. 1970; 170: 460-462
        • Jaeger RJ
        • Rubin RJ
        Migration of phthalate ester plasticizer from polyvinyl-chloride blood bags into stored human blood and its localization in human tissues.
        N Engl J Med. 1972; 287: 1114-1116
        • Thomas JA
        • Thomas MJ
        Biological effects of di(2-ethylhexyl) phthalate and other phthalic acid esters.
        Crit Rev Toxicol. 1984; 4: 283-308
        • Rock G
        • Labow RS
        • Tocchi M
        Distribution of di(2-ethylhexyl) phthalte and products in blood and blood components.
        Environ Health Perspect. 1986; 65: 309-316
        • Valeri CR
        • Contreras TJ
        • Feingold H
        • Sheibley RH
        • Jaeger RJ
        Accumulation of di-2-ethylhexyl phthalate (DEHP) in whole blood, platelet concentrates and platelet-poor plasma. 1. Effect of DEHP on platelet survival and function.
        Environ Health Perspect. 1973; 3: 103-108
        • Jaeger RJ
        • Rubin RJ
        Di-2-ethylhexyl phthalate, a plasticizer contaminent of platelet concentrates.
        Transfusion. 1973; 13: 107-108
        • Contreras TJ
        • Sheibley RH
        • Valeri CR
        Accumulation of di-2-ethylhexyl phthalate (DEHP) in whole blood, platelet concentrates and platelet-poor plasma.
        Transfusion. 1974; 14: 34-46
        • Rock GA
        • Secours VE
        • Franklin CA
        • Chu I
        • Villeneuve DC
        The accumulation of mono-2-ethylhexyl phthalate (MEHP) during storage of whole blood and plasma.
        Transfusion. 1978; 18: 553-558
        • Peck CC
        • Odon DG
        • Friedman HI
        • Albro PW
        • Hass JR
        • Brady JT
        • Jess DA
        Di-2-ethylhexyl phthalate (DEHP) and mono-2-ethylhexyl phthalate (MEHP) accumulation in whole blood and red cell concentrates.
        Transfusion. 1979; 19: 137-146
        • Guess WL
        Safety evaluation of medical plastics.
        Clin Toxicol. 1978; 12: 77-95
        • Northrup SJ
        The leachability of DEHP in fenwal blood packs.
        Technical Review (Fenwal). 1986;
        • Vessman J
        • Reitz G
        Formation of mono(ethylhexyl) phthalate from di (ethylhexylphthalate) in human plasma stored in PVC bags and its presence in fractionated plasma proteins.
        Vox Sang. 1978; 35: 75-80
        • Albro PW
        • Corbett JT
        Distribution of di- and mono-(2-ethylhexyl) phthalate in human plasma.
        Transfusion. 1978; 18: 75-79
        • Sasakawa S
        • Mitomi Y
        Di-2-ethylhexyl phthalate (DEHP) content of blood or blood components stored in plastic bags.
        Vox Sang. 1978; 34: 81-87
        • Marcel YL
        Determination of di-2-ethylhexyl phthalate levels in human blood plasma and cryoprecipitates.
        Environ Health Perspect. 1973; 3: 119-121
        • Kevy SV
        • Button LN
        • Jacobson MS
        Toxicology of plastic devices having contact with blood.
        National Heart and Lung Inst., NIH Contract PHS-72-2968. 1975; (Comprehensive Report, National Technical Information Service Ref. No. PB-247 158/8ST)
        • Stern IJ
        • Miripol JE
        • Izzo RS
        • Lueck JD
        Physiochemical aspects of the extraction in blood and the disposition in rats of di-(2-ethylhexyl) phthalate plasticizers.
        Toxicol Appl Pharmacol. 1977; 41: 507-522
        • Miripol JE
        • Stern OJ
        Decreased accumulation of phthalate plasticizer during storage of blood as packed cells.
        Transfusion. 1977; 17: 21-22
        • Cole RS
        • Tocchi M
        • Franklin CVA
        • Villeneuve DC
        • Rock G
        The enzymatic conversion of DEHP to MEHP in human plasma. (Abstr.).
        in: Presented at XI INt. Congr of Biochemistry. 1979
        • Cole RS
        • Tocchi M
        • Franklin C
        • Villeneuve DC
        • Rock G
        Effect of adenine on the contamination of stored blood by di-(2)ethylhexyl) phthalate and mono-(2)ethylhexyl) phthalate (Abstr.).
        in: Presented at Annual AABB Meeting. 1979
        • Estep TN
        • Miller TJ
        • Hickey GP
        • Miripol JE
        Comparison of di-2-(ethylhexyl) phthalate distribution and red cell integrity in whole blood and adsol suspensions stored in contact with different plastic formulations. (Abstr.).
        in: Presented at Annual AABB Meeting. 1985
        • Gulliksson H
        • Karlman G
        • Segerlind A
        • Gullbring B
        Preservation of red blood cells: Content of microaggregates and di-2-ethylhexylphthalte (DEHP) in red blood cells stored in saline-adenine-glucose-mannitol (SAGM) medium.
        Vox Sang. 1986; 50: 16-20
        • Sasakawa S
        • Tokunaga E
        Physical and chemical changes of ACD-preserved blood: a comparison of blood in glass bottles and plastic bags.
        Vox Sang. 1976; 31: 199-210
        • Stern IJ
        • Carmen RA
        Hemolysis in stored blood: stabilizing effect of phthalate plasticizer. (Abstr.).
        IBST, 1980
        • Rock G
        • Tochi M
        • Tackaberry E
        Plasticized red cells: Good or bad?.
        Transfusion. 1983; 23: 426
        • Estep TN
        • Pedersen RA
        • Miller TJ
        • Stupar KR
        characterization of erythrocyte quality during the refrigerated storage of whole blood containing di-2-(ethylhexyl) phthalate.
        Blood. 1984; 64: 1270-1276
        • Jacobson MS
        • Kevy SV
        • Parkman R
        • Wesoilowski JS
        An in vitro evaluation of a new plasticizer for PVC devices.
        Transfusion. 1980; 20: 443
        • Rock G
        • Tocchi M
        • Ganz PR
        • Tackaberry ES
        Incorporation of plasticizer into red cells during storage.
        Transfusion. 1984; 24: 493-498
        • Horowitz B
        • Rowe AW
        • Stryker MH
        • Van der Sande J
        • Waldman AA
        • Wong S-C
        • Gass JD
        • Woods KR
        Biochemistry of whole blood in poly(ethylene-co-ethylacrylate) experimental blood containers.
        Vox Sang. 1985; 48: 143-149
        • Horowitz B
        • Stryker MH
        • Waldman AA
        • Woods KR
        • Gass JD
        • Drago J
        Stabilization of red blood cells by the plasticizer, diethylhexylphthalate.
        Vox Sang. 1985; 48: 150-155
        • Roth S
        • Seeman P
        All lipid-soluble anaesthetics protect red cells.
        Nature (London) New Biol. 1971; 231: 284-285
        • Labow RS
        • Card RT
        • Rock G
        The effect of the plasticisizer di(2-ethylhexyl-phthalate on red cell deformability.
        Blood. 1987; 70: 319-323
        • AuBuchon JP
        • Davey RJ
        • Estep T
        • Miripol J
        Effect of the plasticizer di-2-ethylhexyl phthalate on survival of stored red cells. (Abstr.).
        in: Presented at Annual AABB Meeting. 1984
        • AuBuchon JP
        • Estep TN
        • Davey RJ
        The effect of the plasticizer di-2-ethylhexyl-phthalate on the survival of stored RBC's.
        Blood. 1988; 71: 448-452
        • Slichter SJ
        • Harker LA
        Preparation and storage of platelet concentrates. II. Storage variables influencing platelet viability and function.
        Br J Haematol. 1976; 34: 403-419
        • Kim SW
        • Petersen RV
        • Lee ES
        Effect of phthalate plasticizer on blood compatibility of polyvinyl chloride.
        J Pharm Sci. 1976; 65: 670-673
        • Rubin RJ
        • Shiffer CA
        Fate in humans of the plasticizer, di-2-ethylhexyl phthalate, arising from transfusion of platelets store in vinyl plastic bags.
        Transfusion. 1976; 16: 330-335
        • Ishikawa Y
        • Honda K
        • Sasakawa S
        • Hatada K
        • Kobayashi H
        Prevention of leakage of di-(2-ethylhexyl)phthalate from blood bags by glow discharge treatment and its effect on aggregability of stored platelets.
        Vox Sang. 1983; 45: 68-76
        • Ishikawa Y
        • Sasakawa S
        Platelet storage in glow discharge-treated polyvinylchloride bags: effects of a plasticizer on platelet hypotonic shock response.
        Vox Sang. 1984; 47: 330-334
        • Labow RS
        • Tocchi M
        • Rock G
        Platelet storage. Effects of leachible materials on morphology and function.
        Transfusion. 1986; 26: 351-357
        • Labow RS
        • Tocchi M
        • Rock G
        Contamination of platelet storage bags by phthalate esters.
        J Toxicol Environ Health. 1986; 19: 591-598
        • Fratantoni JC
        • Sturdivant B
        • Poindexter BJ
        Aberrent morphology of platelets stored in five day containers.
        Thromb Res. 1984; 33: 607-625
        • Lindberg JE
        • Slichter SJ
        • Murphy S
        • Schroeder DD
        • Nelson EJ
        • Champion AB
        • Carmen RA
        In vitro function and in vivo viability of stored platelet concentrates: effect of a secondary plasticizer component of PVC storage bags.
        Transfusion. 1983; 23: 294-299
        • Snyder EL
        • Koerner TAW
        • Kakaiya R
        • Moore P
        • Kiraly T
        Effect of mode of agitation on storage of platelet concentrates in PL-732 containers for 5 days.
        Vox Sang. 1983; : 44300-44304
        • Snyder EL
        • Bookbinder M
        • Kakaiya R
        • Ferri P
        • Kiraly T
        5-day storage of platelet concentrates in CLX containers: effect of type of agitation.
        Vox Sang. 1983; 45: 432-437
        • Grode G
        • Miripol J
        • Garber J
        • Barber T
        • Buchholz DH
        Extended storage of platelets in a new plastic container I. Biochemical and morphologic changes.
        Transfusion. 1985; 25: 204-208