Storage of red blood cells affects membrane composition, microvesiculation, and in vitro quality.

Author(s): Almizraq R, Tchir JD, Holovati JL, Acker JP

Publication: Transfusion, 2013, Vol. 53, Page 2258-67

PubMed ID: 23320518 PubMed Review Paper? No

Purpose of Paper

Conclusion of Paper

Studies

1. Study Purpose

   The purpose of this study was to determine the effects of refrigerated storage on markers of RBC quality. Blood was stored at room temperature for up to 24 h before leukoreduction and processing to RBCs in citrate-phosphate-dextrose (CPD)-saline adenine glucose mannitol (SAGM).

   Summary of Findings:

   During refrigerated storage of RBCs, significant declines in ATP content (p<0.001), EImax (p<0.001), MCH (p=0.001), MCHC (p<0.001) and morphology scores (p<0.001) were observed as well as increases in hemolysis (p<0.001) and osmotic fragility (p<0.001). Importantly, during refrigerated storage, MCH and MCHC fell below the normal range in some specimens. However, in all specimens, hemolysis remained <0.8%, and neither the stress required to reach EImax (K-EI) nor the mean corpuscular volume (MCV) were affected by refrigerated storage of RBCs.

   Biospecimens

   • Cell - Red Blood Cells

   Preservative Types

   • Other Preservative

   Diagnoses:

   • Normal

   Platform:

   Analyte	Technology Platform
   Small molecule	Spectrophotometry
   Cell count/volume	Spectrophotometry
   Cell count/volume	Hematology/ auto analyzer
   Morphology	Hematology/ auto analyzer
   Morphology	Spectrophotometry

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Storage	Storage duration	2 days 7 days 14 days 28 days 35 days 42 days 49 days

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2. Study Purpose

   The purpose of this study was to determine the effects of refrigerated storage on RBC membrane phospholipid and cholesterol content. Blood was stored at room temperature for up to 24 h before leukoreduction and processing to RBCs in CPD-SAGM. Cholesterol and phospholipid extracts were obtained on days 2 and 42 of experimental refrigerated storage and stored at -80 degrees C until analysis.

   Summary of Findings:

   After 42 days of refrigerated storage, significantly less combined total phospholipids and lipids (p<0.001), phosphatidylethanolamine (PE, P=0.002), phosphatidylserine (PS, p=0.010), phosphatidylcholine (PC, p=0.004), sphingomyelin (SM, p=0.024), and lysophosphatidylcholine (LPC, p=0.020) were present in the RBC membranes than on day 2 of refrigerated storage. However, PI and cholesterol membrane content was not affected by refrigerated storage of RBCs. Further, the relative concentration of the different phospholipid and lipid types was different between day 2 and 42 of refrigerated storage. The cholesterol to total phospholipid ratio during refrigerated storage was strongly correlated with EImax (r2=0.87), modestly correlated with ATP concentrations (R2=0.57), and weakly correlated with hemolysis (R2=0.037).

   Biospecimens

   • Cell - Red Blood Cells

   Preservative Types

   • Other Preservative

   Diagnoses:

   • Normal

   Platform:

   Analyte	Technology Platform
   Lipid	HPLC-MS
   Steroid	HPLC

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Storage	Storage duration	2 days 42 days

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3. Study Purpose

   The purpose of this study was to determine the effects of refrigerated storage on the RMP and RBC expression of PS and CD47. Blood was stored at room temperature for up to 24 h before leukoreduction and processing to RBCs in CPD-SAGM.

   Summary of Findings:

   RMPs increased during refrigerated storage of RBCs with significantly higher levels observed after 42 and 49 days than after 2 days (p<0.05). While the percentages of RMPs and RBCs expressing PS were not altered by refrigerated storage, the MFI of PS in RMPs and RBCs was significantly lower after 35 days of storage compared to day 2 (p<0.05). While the percentage of RMPs expressing CD47 was lower on days 28-42 than on day 2 (p<0.05), the MFI of CD47 in RMPs was only lower after 42 or 49 days of storage compared to 2 days (p<0.05), and neither the percentage of RBCs expressing CD47 nor the MFI of CD47 in RBCs were affected by storage.

   Biospecimens

   • Cell - Red Blood Cells

   Preservative Types

   • Other Preservative

   Diagnoses:

   • Normal

   Platform:

   Analyte	Technology Platform
   Cell count/volume	Flow cytometry

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Storage	Storage duration	2 days 7 days 14 days 21 days 28 days 35 days 42 days 49 days

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