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Invited Review



Storage lesions in blood components

Rajashekharaiah Vani, Ravikumar Soumya, Krishnegowda Manasa, Hsieh Carl.


Abstract

Blood transfusion is a life-saving intervention and refers to the use of blood and its components for therapy. Transfusion supports various forms of medical care and hence, there is an ever-increasing need and demand for blood. The main principles of transfusion lie in safe and effective blood supply. In order to ensure sufficient quality of blood transfused and to prevent wastage, component therapy was introduced. It involves the transfusion of specific component(s) rather than whole blood.
This review explores the history of storage; changes occurring during storage and the current developments in storage techniques of blood and its components. Blood and its components can be stored under various conditions with the addition of additive solutions. Whole blood can be stored up to 35 days, while erythrocytes can be stored up to 42 days at 4°C. Platelets are stored at 22-24°C for 5-7 days. Plasma can be stored at -18◦C for 1 year, or at -65◦C for 7 years. The storage solutions vary for each component and efficient storage solutions are under development.
The storage of blood and its components in ex vivo conditions causes the formation of storage lesions. These storage lesions, in turn cause decreases in the functioning and efficacy of the transfusion. Oxidative stress plays a key role in the formation of the storage lesion. The effects of oxidative stress can be combated to a certain degree by the inherent antioxidant defense system. However, further stress leads to severe irreversible damage to blood and its components, deeming them unfit for transfusion. The prospects of antioxidants as additives in storage needs to be explored.
There is still a dire necessity to develop better management techniques of blood storage and hence, improve the efficacy and shelf life of stored blood.

Key words: Component therapy, erythrocytes, plasma, platelets, transfusion






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