Prolonged Storage of Red Blood Cells for Transfusion in Citrate Phosphate Dextrose Adenine-1 Affects Their Viability

Most donor blood units for transfusion purposes are stored in Citrate Phosphate Dextrose Adenine-1 (CPDA-1) at blood-banks until used. Despite improvements made in blood storage attempts, CPDA-1 may still cause morphological and degenerative changes in red blood cells (RBCs) if storage is prolonged. The purpose of the study was to assess the viability of RBCs through characteristic changes resulting from prolonged storage in CPDA-1. A total of fifteen whole blood stored in CPDA-1 were analyzed for changes in erythrocytes morphology, Packed Cell Volume (PCV) and osmotic fragility in a seven day interval over a thirty-five day period. On day 1 (control), samples were analyzed within 6 hours of collection, and subsequently taken to the blood bank to be stored and re-analyzed from days 7 to 35. Mean Cell Fragility (MCF) which is suggestive of RBC membrane instability showed changes that were statistically significant between days 1 and 35. Morphological changes observed over the storage period included spherocytosis, echinocytosis, and marked sphero-echinocytosis with increased rouleaux formation. PCV value decreased marginally over the period. The author concluded that donor blood units stored for longer periods may result in RBC defects, affecting their viability and consequently interfere with expected therapeutic outcomes.