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.

Authors

Carly Olafson, Sanaz Hemmatibardehshahi, Geraldine M Walsh, Anita Howell

Published in

Vox sanguinis. Jul 19, 2026. Epub Jul 19, 2026.

Abstract

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.
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).
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.
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.

PMID:
42472675
Bibliographic data and abstract were imported from PubMed on 20 Jul 2026.

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