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Updated: Feb 3, 2026
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Measuring Single-Cell Aging with an Imaging-based Biomarker of Chromatin and Epigenetic Aging
Published on: January 30, 2026
8
Real Age: Red Blood Cell Aging During Storage.
Colleen G Koch1, Andra I Duncan2, Priscilla Figueroa3
1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medicine, Baltimore, Maryland.
The Annals of Thoracic Surgery
|October 21, 2018
Summary
Red blood cell (RBC) units age differently in storage. Functional measures of RBC quality, or "real age," may be better than the standard 42-day limit for assessing blood product suitability.
Area of Science:
- Hematology
- Transfusion Medicine
- Biochemistry
Background:
- Red blood cell (RBC) units exhibit variable aging rates during cold storage.
- The Food and Drug Administration mandates a uniform 42-day storage limit for RBCs.
- Evidence suggests an RBC storage lesion impacts blood product quality over time.
Purpose of the Study:
- To present evidence for the RBC storage lesion.
- To propose functional measures of RBC quality ('real age') as superior to calendar age.
- To explore improved donor selection, storage, and transfusion efficacy.
Main Methods:
- Review of existing evidence on RBC degradation during storage.
- Analysis of factors influencing RBC aging, including donor characteristics and bio-preservation.
- Examination of biochemical and morphological changes in stored RBCs.
Main Results:
- In vitro aging data show significant RBC changes beyond 28-35 days.
- Clinical trials often use RBC units that are not sufficiently aged to reflect in vitro changes.
- Average storage age in trials for older units was 14-21 days, not capturing full aging effects.
Conclusions:
- Real age of RBC products varies due to donor factors, storage, and biological changes.
- Metrics assessing temporal quality changes are more appropriate than a fixed 42-day expiration.
- Precision medicine necessitates acknowledging potential harm to vulnerable populations from aged blood products.
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