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An acid-citrate dextrose solution which contains phosphoenolpyruvate and sucrose was used as a preservative and medium for rejuvenating depleted erythrocytes. 2,3-bisphosphoglycerate and ATP in washed erythrocytes, red cell concentrate or whole blood were increased effectively by incubating the cells with the solution at 37 degrees C for 30--60 min. The transport of phosphoenolpyruvate through the erythrocyte membrane was essential to the increase of 2,3-bisphosphoglycerate and ATP. During storage of the cells at 4 degrees C in the presence of phosphoenolpyruvate, no increase of 2,3-bisphosphoglycerate and ATP was observed because no transport of phosphoenolpyruvate into the cells occurred. By an incubation at 37 degrees C for 30 min at the end of storage periods, however, levels of ATP and 2,3-bisphosphoglycerate in the cells were raised.
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