Impact of different standard red blood cell storage temperatures on human and canine RBC hemolysis and chromium survival

Abstract

BACKGROUND Storage temperature is a critical factor for maintaining red-blood cell (RBC) viability, especially during prolonged cold storage. The target range of 1 to 6°C was established decades ago and may no longer be optimal for current blood-banking practices. STUDY DESIGN AND METHODS Human and canine RBCs were collected under standard conditions and stored in precision-controlled refrigerators at 2°C, 4°C, or 6°C. RESULTS During 42-day storage, human and canine RBCs showed progressive increases in supernatant non-transferrin-bound iron, cell-free hemoglobin, base deficit, and lactate levels that were overall greater at 6°C and 4°C than at 2°C. Animals transfused with 7-day-old RBCs had similar plasma cell-free hemoglobin and non-transferrin-bound iron levels at 1 to 72 hours for all three temperature conditions by chromium-51 recovery analysis. However, animals transfused with 35-day-old RBCs stored at higher temperatures developed plasma elevations in non–transferrin-bound iron and cell-free hemoglobin at 24 and 72 hours. Despite apparent impaired 35-day storage at 4°C and 6°C compared to 2°C, posttransfusion chromium-51 recovery at 24 hours was superior at higher temperatures. This finding was confounded by a preparation artifact related to an interaction between temperature and storage duration that leads to removal of fragile cells with repeated washing of the radiolabeled RBC test sample and renders the test sample unrepresentative of the stored unit. CONCLUSIONS RBCs stored at the lower bounds of the temperature range are less metabolically active and produce less anaerobic acidosis and hemolysis, leading to a more suitable transfusion product. The higher refrigeration temperatures are not optimal during extended RBC storage and may confound chromium viability studies.

Improving the Stability of Red Blood Cells in Rainbow Trout (Oncorhynchus mykiss) and Herring (Clupea harengus): Potential Solutions for Post-mortem Fish Handling to Minimize Lipid Oxidation

“…In our study, less hemolysis was found at 0-6°C, with a minimum at 2.5°C (Fig. 3 a-c), which is in agreement with the results of (Blaine et al 2019), who found that storage at 2°C give better viability of human RBCs which they ascribed reduced RBC metabolism, such as slower pH drop due to slower formation of lactate. Furthermore, the FDA-approved storage temperature of human RBCs is at 1-6°C (FDA 2018).…”

“…Similarly, high osmotic pressure could appear, e.g., in pre-salting and marinating steps which comprise salt solutions from om 3% up to saturation. Other factors which could be critical to RBCs would be the mechanical stress which appears, e.g., during transport and sorting of fish, as well as temperature fluctuations (Blaine et al 2019). Although the temperature is normally close to 0°C early in the process chain (Grahm et al 1992;Huss 1995), it can raise, e.g., in filleting and washing steps and in the handling of by-products (Kuhlin 2019).…”

Effect of washing units of canine red blood cells on storage lesions

“…Similar to previous studies, our study demonstrated an increase in lactate concentrations and pCO 2 during storage. 14 , 28 , 29 , 30 During storage, erythrocyte metabolic function is more dependent on anaerobic metabolism, which requires the conversion of intra‐cellular pyruvate to lactic acid. 28 , 31 During storage, the erythrocyte intracellular concentration of 2,3‐diphosphoglycerage (2,3‐DPG) decreases, which reduces RBC oxygen carrying capacity and promotes anaerobic metabolism.…”

“…In both human and veterinary medicine, storage of blood products can increase erythrocyte fragility, causing an increase in in vitro hemolysis and free Hgb concentrations. 15 , 29 , 36 , 37 , 38 An increase in red cell fragility and hemolysis can result in the release of cell‐free Hgb, which can contribute to multiple organ failure, 39 lung injury, 40 , 41 , 42 , 43 , 44 bacterial infections, 19 systemic and pulmonary hypertension, 40 kidney injury, and endothelial dysfunction. 21 Hemoglobin effectively scavenges nitric oxide, causing endothelial dysfunction, vasoconstriction, platelet aggregation, increased vascular permeability, and leukocyte adhesion.…”

RBC Storage Lesion Studies in Humans and Experimental Models of Shock

“…We next examined the influence of storage temperature on RBC viability using ex vivo human and canine RBCs as well as in vivo radiochromium-labeled RBC transfusions in canines [20]. The 1-6…”