Red blood cell storage time and transfusion: current practice, concerns and future perspectives

Area of Science:

• Blood banking and transfusion medicine
• Cellular biology
• Omics technologies

Background:

• Red blood cells (RBCs) are the most transfused product globally, essential for tissue oxygen delivery.
• Stored RBCs undergo a "storage lesion" affecting their quality and potentially leading to adverse clinical outcomes.
• Current understanding of "old" versus "young" RBC transfusion effects remains debated, necessitating better quality assessment.

Purpose of the Study:

• To investigate the impact of RBC storage on unit quality and explore alternative markers for efficacy and safety.
• To understand the role of microparticles (MPs) in stored RBC units using Omics approaches.
• To pave the way for personalized transfusion strategies and novel cell-based therapies.

Main Methods:

• Application of unbiased Omics approaches to characterize RBCs during storage.
• Analysis of microparticles (MPs) present in both young and old RBC units.
• Comparative analysis of "young" and "old" RBC unit components, including MPs, donors, and recipients.

Main Results:

• Storage time may not be a reliable indicator of RBC unit quality.
• Omics characterization is revealing the physiological role of MPs in stored RBCs.
• Potential for developing new therapies using engineered RBCs or MPs for drug delivery.

Conclusions:

• There is a need to establish reliable parameters reflecting RBC efficacy and safety beyond storage duration.
• Further Omics characterization can inform personalized transfusion strategies.
• Engineered RBCs and MPs hold promise for advanced therapeutic applications.