Exposure to sub-zero temperatures down to -11 °C does not impact packed red cells storage quality

Area of Science:

• Transfusion Medicine
• Blood Storage
• Cryobiology

Background:

• European guidelines mandate packed red blood cells (pRBC) storage between 2-6°C.
• Prehospital transfusions face risks of negative temperature shifts.
• Investigating sub-zero temperature effects on pRBC quality is crucial for transfusion safety.

Purpose of the Study:

• To assess the impact of short-term sub-zero temperature exposure on pRBC storage quality.
• To determine if pRBCs exposed to temperatures down to -11°C maintain storage standards.
• To evaluate pRBCs' transfusion recovery potential after sub-zero exposure.

Main Methods:

• Three cohorts of pRBCs were exposed to -1°C, -5°C, and -11°C for 10 hours at day 6 post-donation.
• A control cohort was maintained under standard conditions.
• Hemolysis, pH, plasma biochemistry, and storage-induced micro-erythrocytes (SMEs) were measured weekly until day 49.

Main Results:

• All sub-zero exposed pRBC cohorts met European storage standards at day 42.
• No statistically or clinically significant differences were observed in hemolysis, pH, plasma biochemistry, or SMEs compared to controls.
• Sub-zero exposure down to -11°C for 10 hours did not compromise pRBC storage quality.

Conclusions:

• Short-term exposure of pRBCs to sub-zero temperatures, even down to -11°C, does not significantly impair storage quality.
• These findings support a more informed risk assessment for using pRBCs in prehospital settings.
• Maintaining pRBC quality under potential adverse temperature conditions enhances transfusion safety and efficacy.