Hitchhiker’s guide to the red blood cell storage lesion

Abstract

Preview
Transfusions of red blood cells are therapeutically important in acute and chronic conditions (e.g., trauma and sickle cell disease, respectively). Indeed, they represent the most common therapeutic intervention in hospitalised patients1. For example, in the United States of America, ~11 million units of RBCs are transfused annually into ~5 million recipients, meaning that one out of every ~65 Americans receives a transfusion every year.
However, to be of practical usefulness, some sort of method is required to store the red blood cells so that they are available when needed. Thus, although some exceptions exist, such as the "walking blood banks" in military settings, the most common approach is to store red blood cell units under refrigerated conditions. For example, in most countries, using modern storage solutions (e.g., AS-3 in the United States and saline-adenine-glucose-mannitol [SAGM] in Europe), refrigerated red blood cell units can now be stored for up to 42 days before use. [ … ]