Impact of constant storage temperatures and multiple warming cycles on the quality of stored red blood cells

Abstract

Red cells can be kept at constant temperatures above 6°C without apparent harmful effects at least until day 14, whereas multiple warming cycles for no longer than 24 h at 10, 13 or 22°C with subsequent cooling do not cause quality loss as assessed using the in vitro assays employed in this study.

Quality and safety of red blood cells stored in two additive solutions subjected to multiple room temperature exposures

“…Wagner et al . recently reported the acceptable in vitro quality of RBC units warmed up to 13°C for a maximum of 24 h, once a week during the 42 days of storage . Thomas et al .…”

Transition to 37°C reveals importance of NADPH in mitigating oxidative stress in stored RBCs

“…Upon entering the circulation, transfused RBCs become rapidly exposed to body temperature (37°C). The temperature transition to 37°C may exacerbate the biochemical and pathological alterations that have slowly accumulated during storage at 4°C, and this may be related to posttransfusion loss of RBCs and subsequent adverse events in vivo (14,15).…”

Logistical and safety implications of temperature‐based acceptance of returned red blood cell units

“…Many studies have described the impact of stationary, nontransport, room temperature warming on various in vitro RBC quality measures, including hemolysis, PaO 2 , PaCO 2 , and pH; bacterial growth; mechanical fragility; deformability; and concentrations of glucose, lactate, sodium, potassium, adenosine triphosphate, and 2,3‐diphosphoglycerate . No published studies have examined the impact of realistic hospital transport RBC warming on adverse transfusion outcomes, and only one published study has examined RBC warming kinetics in a realistic transport setting using temperature‐sensitive indicators, but did not investigate patient outcomes …”

“…[6][7][8][9][10] Many studies have described the impact of stationary, nontransport, room temperature warming on various in vitro RBC quality measures, including hemolysis, PaO 2 , PaCO 2 , and pH; bacterial growth; mechanical fragility; deformability; and concentrations of glucose, lactate, sodium, potassium, adenosine triphosphate, and 2,3diphosphoglycerate. 2,[11][12][13][14][15] No published studies have examined the impact of realistic hospital transport RBC warming on adverse transfusion outcomes, and only one published study has examined RBC warming kinetics in a realistic transport setting using temperature-sensitive indicators, but did not investigate patient outcomes. 5 The present study aims to examine the warming kinetics of RBC units issued outside of qualified containers in a hospital transport setting, and to compare the logistical and safety impact between the 30-minute rule and a temperature-based acceptance strategy on RBC units transported without temperature control.…”