Abstract
Red blood cell (RBC) transfusion is one of the most common therapeutic procedures in modern medicine. Although frequently lifesaving, it often has deleterious side effects. RBC quality is one of the critical factors for transfusion efficacy and safety. The role of various factors in the cells’ ability to maintain their functionality during storage is widely discussed in professional literature. Thus, the extra- and intracellular factors inducing an accelerated RBC aging need to be identified and therapeutically modified. Despite the extensively studied in vivo effect of chronic hyperglycemia on RBC hemodynamic and metabolic properties, as well as on their lifespan, only limited attention has been directed at the high sugar concentration in RBCs storage media, a possible cause of damage to red blood cells. This mini-review aims to compare the biophysical and biochemical changes observed in the red blood cells during cold storage and in patients with non-insulin-dependent diabetes mellitus (NIDDM). Given the well-described corresponding RBC alterations in NIDDM and during cold storage, we may regard the stored (especially long-stored) RBCs as “quasi-diabetic”. Keeping in mind that these RBC modifications may be crucial for the initial steps of microvascular pathogenesis, suitable preventive care for the transfused patients should be considered. We hope that our hypothesis will stimulate targeted experimental research to establish a relationship between a high sugar concentration in a storage medium and a deterioration in cells’ functional properties during storage.
Highlights
Red Blood Cells TransfusionIn everyday blood banking practice, the storage duration is considered as the primary criterion for inventory management, and except for special cases, such as newborns or multi-transfused patients, the packed RBC (PRBC) units are supplied primarily according to the first-in-first-out (FIFO) principle
Red blood cell (RBC) transfusion is one of the most common therapeutic procedures in modern medicine
In everyday blood banking practice, the storage duration is considered as the primary criterion for inventory management, and except for special cases, such as newborns or multi-transfused patients, the packed RBC (PRBC) units are supplied primarily according to the first-in-first-out (FIFO) principle
Summary
In everyday blood banking practice, the storage duration is considered as the primary criterion for inventory management, and except for special cases, such as newborns or multi-transfused patients, the PRBC units are supplied primarily according to the first-in-first-out (FIFO) principle. In this case, the “calendar age” of the unit is accepted as a master parameter, while the actual quality of the cells provided for transfusion, their capacity to provide the expected transfusion outcome, is not addressed. It is important to emphasize that there is much in common in the process of RBC aging under both conditions, a significant difference in the in vivo and in vitro aging of erythrocytes has been documented
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