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Dip Ghosh: How CPDA-1 Keeps Transfusions Safe and Effective

Dip Ghosh/LinkedIn

May 23, 2026, 11:21

Dip Ghosh: How CPDA-1 Keeps Transfusions Safe and Effective

Dip Ghosh, Student at North South University, shared a post on LinkedIn:

“A single unit of blood can save multiple lives – but only if science preserves it effectively before transfusion.

Behind every safe transfusion lies CPDA-1 (Citrate Phosphate Dextrose Adenine), a preservative-anticoagulant solution that revolutionized blood banking by extending red blood cell (RBC) storage while maintaining cellular viability and function.

Each component plays a unique role:

Citrate – Prevents coagulation by binding calcium ions and interrupting the clotting cascade.
Phosphate – Supports ATP production and stabilizes pH balance.
Dextrose – Provides glucose for glycolysis, the main energy source for RBC survival.
Adenine – Enhances ATP synthesis, helping preserve membrane integrity and post-transfusion survival.

With refrigeration at 1–6°C, CPDA-1 can preserve RBCs for up to 35 days, improving blood availability for trauma care, surgery, oncology, and emergency medicine.

According to the World Health Organization, more than 118 million blood donations are collected globally every year, making effective blood preservation essential for modern healthcare (World Health Organization [WHO], 2024).

Research shows that maintaining ATP levels is critical because red blood cells lack mitochondria and rely entirely on glycolysis for energy production (Hess, 2010).

ATP preservation helps maintain membrane flexibility, ion transport, and overall cell survival during storage.

However, even under optimal conditions, stored blood develops ‘storage lesions,’ including:

Decreased ATP levels
Reduced 2,3-BPG
Potassium leakage
Oxidative membrane damage
Shape changes and progressive hemolysis

Studies suggest that reduced 2,3-BPG can impair oxygen release from hemoglobin, potentially affecting tissue oxygenation after transfusion (Yoshida et al., 2019). Potassium accumulation may also become clinically significant during massive or neonatal transfusions (Zimring, 2015).

International quality standards require stored RBCs to maintain approximately 75% survival 24 hours after transfusion, highlighting the importance of preservation science (Hess, 2010).

Modern transfusion medicine continues evolving through additive solutions, leukoreduction, pathogen reduction technology, and advanced storage research to improve patient outcomes.

For laboratory professionals, understanding CPDA-1 is more than theory – it directly supports: