The use of the mechanical fragility test in evaluating sublethal RBC injury during storage

Area of Science:

• Hematology
• Biomaterials Science
• Biophysics

Background:

• The mechanical fragility index (MFI) quantifies sublethal injury in red blood cells (RBCs).
• Sublethal injury is a potential component of RBC storage lesion.
• MFI was assessed during routine RBC storage to investigate its changes over time.

Purpose of the Study:

• To determine how RBC mechanical fragility changes during routine storage.
• To investigate the influence of preservation solutions (AS-5 and SAGM) and gender on RBC mechanical fragility.
• To explore the potential of MFI as a metric for evaluating RBC storage interventions.

Main Methods:

• Leucoreduced RBC units preserved in AS-5 and SAGM solutions were stored under standard blood bank conditions.
• The mechanical fragility (MF) of RBCs was measured serially throughout the storage period.

Main Results:

• RBC mechanical fragility significantly increased in both AS-5 and SAGM units during storage.
• AS-5 preserved RBCs exhibited significantly lower MFI compared to SAGM preserved RBCs.
• Female RBCs consistently showed significantly lower MFI than male RBCs in both preservation solutions.
• No significant MFI differences were found between ABO groups for AS-5 preserved RBCs.

Conclusions:

• RBC mechanical fragility increases with storage duration.
• Both gender and preservation solution impact RBC mechanical fragility.
• Gender-based differences in MFI appear independent of the storage solution used.
• MFI serves as a potential indicator for assessing interventions aimed at reducing RBC storage-related injury.