Erythrocytes or red blood cells (RBCs) are unique cells that supply sufficient oxygen to tissues to fuel oxidative phosphorylation for efficient energy production. RBCs survive in the human circulation system for approximately 120 days. During this time, they accumulate oxidative damage and are promptly removed by the reticuloendothelial system.
Packed RBC storage in the blood bank is a logistic necessity, making approximately 100 million blood units available for transfusion every year worldwide. However, as RBCs are stored up to 42 days under refrigerated conditions (+4oC), whether after leukoreduction or not, they accumulate a series of biochemical and morphological changes, collectively referred to as the storage lesion1. The erythrocyte storage lesion is affected by biological (the genetic profile such as sex, G6PD, Hb traits) and environmental (donor age, diet, and smoking habits) factors. Such alterations are primarily driven by oxidant stress2 and target redox sensitive metabolic enzymes3 upstream to 2,3-diphosphoglycerate (DPG) and adenosine triphosphate (ATP) synthesis, thus resulting in the depletion of these metabolites. This phenomenon in turn alters RBC oxygen kinetics, due to the role of DPG and ATP in the modulation of hemoglobin allostery4. [ ... ]
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