Donor‐variation effect on red blood cell storage lesion: A close relationship emerges

Abstract

Although the molecular pathways leading to the progressive deterioration of stored red blood cells (RBC storage lesion) and the clinical relevance of storage-induced changes remain uncertain, substantial donor-specific variability in RBC performance during storage, and posttransfusion has been established ("donor-variation effect"). In-bag hemolysis and numerous properties of the RBC units that may affect transfusion efficacy have proved to be strongly donor-specific. Donor-variation effect may lead to the production of highly unequal blood labile products even when similar storage strategy and duration are applied. Genetic, undiagnosed/subclinical medical conditions and lifestyle factors that affect RBC characteristics at baseline, including RBC lifespan, energy metabolism, and sensitivity to oxidative stress, are all likely to influence the storage capacity of individual donors' cells, although not evident by the donor's health or hematological status at blood donation. Consequently, baseline characteristics of the donors, such as membrane peroxiredoxin-2 and serum uric acid concentration, have been proposed as candidate biomarkers of storage quality. This review article focuses on specific factors that might contribute to the donor-variation effect and emphasizes the emerging need for using omics-based technologies in association with in vitro and in vivo transfusion models and clinical trials to discover biomarkers of storage quality and posttransfusion recovery in donor blood.

Biomarkers defining the metabolic age of red blood cells during cold storage

“…36 Interdonor variability, blood processing, as well as sex effects, might also affect the metabolic phases of RBC concentrates. [37][38][39] In the present study, we did not find significant sex-related metabolic signatures. However, we are aware that sex effects might influence the quality of RBCs.…”

Transfusion of autologous extracellular vesicles from stored red blood cells does not affect coagulation in a model of human endotoxemia

“…Another limitation of our study is that it cannot be excluded that a higher dose of EVs, for example, after multiple transfusion or in products from “bad donors,” can alter coagulation. Also, although the study was powered, variability may have been too large to detect a difference, which would be detected using a larger sample size.…”

Deformability based sorting of stored red blood cells reveals donor-dependent aging curves

“…A fundamental challenge in the transfusion of donated RBCs is that not all donated RBC units can confer the same benefits to recipients 2,3 . Specifically, transfusion specialists have long been aware that certain RBC units are able to circulate for long periods of time in recipients to maintain hemostasis, while other units are rapidly cleared, leading to the need for repeat transfusions [4][5][6][7][8] . This situation is highly undesirable for chronic transfusion recipients because of potential adverse effects, such as iron-overload, transfusion related acute lung injury (TRALI), hypervolemia, and increased risk of infections [9][10][11][12] .…”