Preservation of red blood cells for transfusion

Development of red blood cell preservative solutions began in the early 1900s. During the 1930s, definition of the glycolytic pathway of red blood cell metabolism provided a rational basis for these studies and contributed to the establishment of standard criteria for satisfactory red blood cell preservation. Recently, the use of adenine in the preservative solution has allowed a 14-day increase in red blood cell storage time. Additional approaches to red blood cell preservation are the use of optional additive solutions and rejuvenation. One major controversial issue is the clinical significance of transfusion of stored red blood cells that are depleted of 2,3-diphosphoglycerate and have a high oxygen affinity.