Abstract
Red blood cells that are stored for transfusions as red cell concentrates (RCCs) undergo changes during the storage period, culminating in the lysis of the cells. The goal of this work is to find markers that are linked to high haemolysis, in order to explain the inter-donor variability that is known to occur in storage quality, and also the known differences between RCCs from male and female donors. The relative amounts of lipids at the end of the storage period were compared for one group of low haemolysis samples (24 units, all ≤0·15% haemolysis), and one group of high haemolysis samples (26 units, all ≥0·5% haemolysis). Representative lipids were analysed from different lipid classes, including cholesterol, phosphatidylcholine, phosphatidylethanolamine, sphingomyelin and ceramide. Whole membrane preparations were analysed with one mass spectrometry technique, and lipid extracts were analysed with a second mass spectrometry technique. The ratio of palmitoyl-oleoyl phosphatidylcholine (POPC) to sphingomyelin was different for the high and low haemolysis groups (P=0·0001) and for the RCCs from male and female donors (P=0·0009). The ratio of cholesterol to phospholipids showed only minimal links to haemolysis. Higher relative amounts of sphingomyelin were associated with lower haemolysis, and higher relative amounts of ceramides were associated with increased haemolysis. The level of sphingomyelinase activity and the resulting ratio of sphingomyelin to POPC is proposed as a possible marker for RCC storage quality.
Highlights
When red blood cells (RBCs) are stored for transfusions, additives in the bags extend the shelf life of the cells, but there are still changes that take place over the course of the storage period
It is of interest to find markers that are linked to the haemolysis; this could aid in prediction of the storage quality at the beginning of the storage period and potentially provide a foundation to build on for storage quality improvements
The red cell concentrates (RCCs) were stored in PAGGSM for 42 days at 2–6°C, after which the haemolysis was measured by the quality control (QC) laboratory that monitors 1% of the units collected in the BadenWu€rttemberg—Hessen region
Summary
When red blood cells (RBCs) are stored for transfusions, additives in the bags extend the shelf life of the cells, but there are still changes that take place over the course of the storage period. The extent of the haemolysis increases with time and renders the unit unsuitable for transfusion if it reaches beyond a threshold level (0Á8%, Europe/Canada; 1%, USA). The goal of this work is to find markers that are linked to high haemolysis, in order to explain the inter-donor variability that is known to occur in storage quality, and the known differences between RCCs from male and female donors
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