(175r) Promising Routes for Mitigating RBC Storage Lesion

Prolonged refrigerated storage of red blood cells (RBCs) leads to a series of deleterious biochemical and morphological alterations, collectively referred to as “storage lesion”, which has significant implications for the quality and efficiency of stored RBC units in clinical settings [1-4]. This study aimed to conduct a comprehensive comparative analysis of the performance of various storage solutions, including additive solution-3 (AS-3), AS-7, saline-adenine-glucose-mannitol (SAGM), and a non-nutrient phosphate-buffered saline (PBS), in preserving RBC integrity and functionality over a 42-day storage period. Additionally, the effects of inducing anaerobic conditions through the novel application of the commercial enzyme EC-Oxyrase® and modulating the pH of the AS-3 solution on RBC storage lesion mitigation were investigated. RBCs were isolated from healthy donors, processed, and suspended in the aforementioned storage solutions at 4^oC and analyzed biweekly for hemolysis (via RBC counts, RBC indices, and hemoglobin concentrations), cell morphology, and size distribution. Statistical analyses, including one-way analysis of variance (ANOVA) and post-hoc Tukey’s tests, were employed to ascertain significant differences among the investigated effects. Our results indicate that SAGM exhibited superior performance in maintaining RBC quality in terms of hemolysis along with RBC count and morphology, while AS-based solutions demonstrated enhanced performance compared to PBS in maintaining RBC indices and minimizing microvesiculation, swelling, and substantial intracellular hemoglobin decline. RBC lesion was attenuated when cells were stored at higher pH values in AS-3, while the presence of EC-Oxyrase® exerted a significant effect only under low pH conditions. Despite the improved performance of certain formulations, further optimization is necessary to minimize potential adverse effects in transfused patients. The insights gleaned from this study contribute to the growing body of knowledge on RBC storage lesion and provide valuable information for the development of novel, efficacious preservative solutions for RBC storage in clinical and research settings.

References:

[1] R.L. Sparrow et al., Blood Transfus. 8 Suppl 3 (2010) s26-30

[2] A. D’Alessandro et al., Transfusion. 55 (2015) 2955-2966

[3] E.K. Meyer et al., Transfusion. 51 (2011) 1574-1579

[4] G.M. D’Amici et al., Blood transfusion = Transufione del sangue. 10 Suppl 2 (2012) s46-54