Hypoxic storage of donor red cells preserves deformability after exposure to plasma from adults with sickle cell disease

• Published in: Transfusion (Philadelphia, Pa.) Pa.), 2023-01, Vol.63 (1), p.193-202
• Main Authors: Karafin, Matthew S., Field, Joshua J., Ilich, Anton, Li, Lang, Qaquish, Bahjat F., Shevkoplyas, Sergey S., Yoshida, Tatsuro
• Format: Article
• Language: English
• Subjects: Adult; Anemia, Sickle Cell; Blood Donors; Blood Preservation; Crises; Deformability; Deformation effects; Effectiveness; Erythrocyte Deformability; Erythrocytes - metabolism; Exposure; Formability; Hemolysis; Humans; Hypoxia; Inflammation; Patients; Plasma; red blood cells; Sickle cell disease; Signs and symptoms; Storage; storage lesion
• ISSN: 0041-1132; 1537-2995; 1537-2995
• DOI: 10.1111/trf.17163

Background Red cell (RBC) transfusions are beneficial for patients with sickle cell disease (SCD), but ex vivo studies suggest that inflamed plasma from patients with SCD during crises may damage these RBCs, diminishing their potential efficacy. The hypoxic storage of RBCs may improve transfusion efficacy by minimizing the storage lesion. We tested the hypotheses that (1) The donor RBCs exposed to the plasma of patients in crisis would have lower deformability and higher hemolysis than those exposed to non‐crisis plasma, and (2) hypoxic storage, compared to standard storage, of donor RBCs could preserve deformability and reduce hemolysis. Study Design and Methods 18 SCD plasma samples from patients who had severe acute‐phase symptoms (A‐plasma; n = 9) or were at a steady‐state (S = plasma; n = 9) were incubated with 16 RBC samples from eight units that were stored either under conventional(CRBC) or hypoxic(HRBC) conditions. Hemolysis and microcapillary deformability assays of these RBCs were analyzed using linear mixed‐effect models after each sample was incubated in patient plasma overnight at 37°C Results Relative deformability was 0.036 higher (p