The glucose-free platelet-additive solution (termed AR solution), developed by Adams and Rock [Transfusion 1988;28:217-220], was modified by adding glucose as an energy substrate for platelets and maltose to prevent platelet lysis and by replacing sodium gluconate with sodium phosphate for better pH maintenance. The new platelet-additive solution (termed Seto solution) contained 90 mM NaCl, 5 mM KCl, 3 mM MgCl2, 17 mM tri-sodium citrate, 4.9 mM NaH2PO4, 20.1 mM Na2HPO4, 23 mM sodium acetate, 28.8 mM maltose, and 23.5 mM glucose with a pH of 7.4. The solution was sterilized by autoclaving in plastic bags in nitrogen to prevent glucose caramelization at high pH. Plasma-poor platelet concentrates prepared by adding Seto solution to the pelleted platelet buttons were stored in a LE-2 polyolefin bag at 22 degrees C with constant agitation for 5 days. The platelets suspended in Seto solution maintained oxygen consumption at a rate of 1.1 nmol/min/10(9) platelets after 5-day storage, with glucose consumption and lactate production rates of 0.5 +/- 0.2 and 1.2 +/- 0.2 nmol/min/10(9) platelets, respectively. This resulted in a final mean pH of 7.0. Those suspended in AR solution ceased glycolysis within 3 days because residual plasma glucose had been consumed. This was associated with decreases in percent hypotonic shock response and aggregation induced by adenosine diphosphate and collagen. Lactate dehydrogenase discharge in AR solution was 5 and 8 times higher at day 3 and day 5, respectively, than that of Seto solution. Morphologically, there were no ballooned platelets after storage in Seto solution.(ABSTRACT TRUNCATED AT 250 WORDS)