A Prospective Study on Storage Related Changes in Packed Red Blood Cells Collected in CPDA-1 and SAGM

Whole blood is separated into components and stored to ensure optimum supply in time of need. During processing and storage, Red Cell Storage Lesions occur and become more pronounced as the storage time lengthens. This study was done to access the storage related changes in PRBCs during 35 days of storage on weekly basis and compare the biochemical changes between the blood collected in Citrate-Phosphate-Dextrose-Adenine-1 (CPDA-1) blood bags and Citrate-Phosphate-Dextrose (CPD) bags with Saline-Adenine-Glucose-Mannitol (SAGM). Total 110 units collected in CPDA-1 and CPD with SAGM bags were analysed prospectively. Plasma Potassium (K+), Lactate dehydrogenase (LDH) and plasma hemoglobin (P.Hb) in the units were measured on Days 0,1 to assess processing related changes and 7,14,21,28 and 35 days to access storage related changes. Percent hemolysis (H%) for the corresponding days was calculated from P.Hb. There was significant increase in K+, LDH, P.Hb and H% in both the groups after processing and during 35 days of storage (p < 0.001). Upon intergroup comparison with increase in storage duration, changes in CPDA-1 were more noticeable as compared to CPD bag with SAGM, changes in K+(48.7 ± 5.4 mg/dL vs. 40.3 ± 9.3 mg/dL p < 0.001), LDH (1649 ± 290 IU/L vs. 1409 ± 447 IU/L p < 0.05), P.Hb (0.316 ± 0.02 gm/dL vs. gm/dL 0.205 ± 0.02 p < 0.001) and H% (0.602 ± 0.07% vs. 0.44 ± 0.06% p < 0.001), respectively. Plasma K+, LDH, P.Hb and H% are significantly increased during storage. PRBCs stored in SAGM showed better preservation of these parameters. The study advocates inclusion of storage lesion markers as part of PRBCs quality assurance measures.