Abstract
Anemia and hemorrhagic shock are leading causes of morbidity and mortality worldwide, and transfusion of human blood products is the ideal treatment for these conditions. As human erythrocytes age during storage in blood banks they undergo many biochemical and structural changes, termed the red blood cell ‘storage lesion’. Specifically, ATP and pH levels decrease as metabolic end products, oxidative stress, cytokines, and cell-free hemoglobin increase. Also, membrane proteins and lipids undergo conformational and organizational changes that result in membrane loss, viscoelastic changes and microparticle formation. As a result, transfusion of aged blood is associated with a host of adverse consequences such as decreased tissue perfusion, increased risk of infection, and increased mortality. This review summarizes current research detailing the known parts of the erythrocyte storage lesion and their physiologic consequences.
About the author
From left to right: Richard Hoehn, Peter Jernigan, and Alex Chang are surgical residents at the University of Cincinnati College of Medicine, currently participating in a research fellowship. Their areas of research interest include blood banking, trauma, and sphingolipids. Timothy Pritts is a trauma surgeon at the University of Cincinnati, with research interests including blood banking, shock and resuscitation, lung injury, and traumatic brain injury. Michael Edwards is the chairman of surgery at the University of Cincinnati, with specific research interests including sphingolipids and translational medicine, and is also an avid car racing enthusiast.
Acknowledgments
TAP was supported in part by grant R01 GM107625 from the National Institute of General Medical Sciences of the US National Institutes of Health. The authors would also like to acknowledge Dr. Erich Gulbins of the University of Duisburg-Essen for his contributions to this project and others.
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