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Dextrose + adenine is a pharmaceutical combination used as a critical metabolic additive in blood preservation and storage solutions to maintain the viability of red blood cells (RBCs) outside the body. Dextrose (D-glucose) serves as the primary substrate for anaerobic glycolysis, which is the sole energy-producing pathway in mature RBCs, providing the adenosine triphosphate (ATP) necessary to maintain cellular integrity and the sodium-potassium pump. Adenine acts as a precursor for the purine salvage pathway, facilitating the synthesis of ATP by providing a substrate for adenine phosphoribosyltransferase. Together, these components prevent the depletion of high-energy phosphates during storage, significantly extending the shelf life of red blood cell units from 21 days to up to 42 days, depending on the accompanying buffer system. This combination is a standard component of anticoagulant-preservative cocktails and additive solutions used in transfusion medicine.
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