This document discusses the history and types of anticoagulants used for blood storage and transfusion. It details the development of different anticoagulant solutions from 1916 to present day, including Rous-Turner solution, Acidified Citrate Dextrose (ACD), Citrate-Phosphate-Dextrose (CPD), and Citrate-Phosphate-Dextrose with Adenine (CPDA-1). These solutions prevent coagulation by chelating calcium or providing nutrients to prolong red blood cell survival for up to 35 days of storage. Common anticoagulants currently used include ACD, CPD, CPDA-1, and heparin.

2. Anticoagulants, commonly known as blood thinners, are chemical
substances that prevent or reduce coagulation of blood, prolonging
the clotting time. These are closely related to antiplatelet drugs
and thrombolytic drugs by manipulating the various pathways of blood
coagulation.
Common anticoagulants are Warfarin and Heparin.

4. • 1916- First anticoagulant preservative- Rous and Turner. It consisted a
citrate-glucose solution. Rous-Turner’s solution was used for storage of
Human blood during the first world war(Mollison 1987).
• 1943- During the Second World War, Acidified Citrate Dextrose(ACD)
solution was introduced- Loutit and Mollison.

5. • 1957- Gibson developed citrate-phosphate-dextrose(CPD).CPD
eventually replaced ACD and became commonly used preservative for
storage of blood cells in liquid form. Shelf-life of blood stored in CPD at
2-4◦C was 21 day.
• 1978- Citrate-phosphate-dextrose with Adenine(CPDA-1).The addition
of adenine improved the synthesis of ATP in the stored blood, which
prolonged the storage of blood cells at 2-4◦C to 35 days.

6. • Acid Citrate Dextrose(ACD)
• Citrate Phosphate Dextrose(CPD)
• Citrate Phosphate Dextrose Adenine(CPDA)
15 ml of ACD, 14 ml of CPD or CPDA is used for preventing 100 ml of
Blood.
Purpose:
• To prevent Coagulation
• To preserve the life and survival of RBC’s so as to have the maximum
post transfusion survival.

7. 
• Citrate: Acts by chelating Calcium.
• Dextrose: Necessary for the metabolism of stored RBCs. It passes from
plasma into the red cells and is utilized for energy production.
• Citric acid: Prevents caramelization of Glucose in citrate dextrose
solution during autoclaving.
• Adenine: Improves the viability of red cells.

8. Citrate
• Calcium-chelating agent
• Prevents coagulation by
interfering with calcium
dependent steps in the
coagulation cascade
Citrate Dextrose
• The dextrose provide nutrient
for red cells.
• Disadvantages:
• Dilution 1:3
• Cannot be heat sterilized
• Risk of infection

9. Acid-citrate-dextrose
• Citric acid, sodium citrate,
and dextrose(pH 5)
• Shelf life of 21 days
• Prevents caramelization of
sugar
• Used in apheresis procedure
Citrate-phosphate-dextrose
• Alkaline pH and PO4 help in
maintaining 2,3-DPG
• Shelf life of 28 days
• CPD is commonly used

10. Citrate-phosphate-dextrose-adenine
(CPDA-1)
• Improves ATP synthesis
• Longer shelf life(35 days)
• Disadvantage: Uric acid stones
Citrate phosphate dextrose adenine 2
(CPDA 2)
• PRC stored in CPDA 1 ran out of
glucose very soon compared to
CPD.
• CPDA 2 contains more glucose
than CPDA 1.
• Disadvantage: plasma and
platelets loaded with sugar.

11. Other types of Anticoagulants:
Besides, there are many
anticoagulants are used in
hematology and in Blood bank
such as EDTA,Double oxalate,
Heparin, Sodium fluoride,etc.