Effect of bilirubin on stored red blood cells

Bilirubin may cause haemolysis of red cells, especially in the presence of light. The possible dependence of this effect on the metabolic state of the cells has been investigated. For this purpose erythrocytes were stored up to five days to deplete the concentration of ATP. Every day a constant amount of bilirubin was added to the cells. On third day of storage bilirubin induced haemolysis, which was aggravated rapidly during further storage. Bilirubin-induced haemolysis could be reduced after increasing the ATP levels by incubation of the red cells with inosine.