Commentary on 50 years of research at the NBRL, Boston, Massachusetts

Abstract

Research at the NBRL, Boston, MA over the past 50 years assessed the survival and function of RBC and platelets and the function of plasma clotting proteins. Liquid preserved RBC can be stored at 4 °C for only 2 weeks to maintain a 24-hour posttransfusion survival value of 75%, moderately impaired oxygen transport function after transfusion, exert a hemostatic effect, and increase the plasma volume. Liquid preserved platelets can be stored at room temperature with agitation for only 2 days to have acceptable in vivo survival 2 hours following transfusion, normal lifespan, and a hemostatic effect to reduce the bleeding time in thrombocytopenic patients. RBCs frozen with 40% W/V glycerol at -80 °C for at least 10 years, thawed, and deglycerolized in the Haemonetics ACP215 can be stored in Nutricel at 4 °C for 2 weeks with a 24-hour posttransfusion survival of 75%, moderately impaired oxygen transport function after transfusion, exert a hemostatic effect and increase the plasma volume. Leukoreduced single donor platelets treated with 6% DMSO, the supernatant DMSO removed prior to freezing at -80 °C for 2 years, thawed, and diluted with 0.9% NaCl or AB plasma have a bimodal population of platelets: one population has reduced in vivo survival, but increased hemostatic effect and the other has normal in vivo survival. AB plasma can be stored at -80 °C for at least 14 years, thawed, and stored at 4 °C for 24 hours with acceptable in vitro function of clotting proteins. The data reported by the NBRL, Boston, Mass. over the past 50 years and the 15-year experience by the Netherlands military now recommend that FDA, ARC, HHS and DOD should support the use of universal donor frozen group O Rh positive and group O Rh negative RBC, frozen group O platelets and frozen AB plasma from male donors. The frozen blood products will eliminate the severe adverse events of mortality and morbidity associated with the current FDA approved red blood cell products, platelet products, and plasma.