The possibility of adenine-toxicity due to Transfusion of red cells preserved in mannitol-adenine-phosphate solution.

One unit of red cells preserved in mannitol-adenine-phosphate solution (RC-MAP) contains 7mg of adenine. Exogenous adenine is metabolized rapidly into adenine nucleotide pool by adenine phosphoribosyltransferase (APRT). This enzyme defect results in an inability to salvage the purine base adenine, which is oxidized to 2, 8-dihydroxyadenine (2, 8-DHA) by oxanthine oxidase. Excessive amounts of 2, 8-DHA is insoluble, and produces the formation of kidney stones. We examined the possibilities of adenine-toxicity using RC-MAP.The concentration of adenine stored for 5 days reduced to 10% in RC-MAP with normal APRT activity and heterozygous APRT deficiency. In that with homozygous APRT deficiency, adenine still remained more than 80% after the storage of 6 weeks. The frequency of heterozygosity for APRT deficiency in Japanese had been estimated to be 1.2%, although we could not discover APRT deficiency among 500 blood donors. It is, therefore, considered to be a rare chance that both blood donor and the patient are homozygous APRT deficiency. It seems to be infeasible of the occurrence of adeninetoxicity using RC-MAP.