Hemoglobin Oxidation in Stored Blood Accelerates Hemolysis and Oxidative Injury to Red Blood Cells

Introduction: Maintaining blood supply is a challenge in blood banks. Red blood cells stored at 4 °C have issues of biochemical changes due to metabolism of cells leading to biochemical changes, collectively referred to as “storage lesions”. Oxidation of the red cell membrane leading to lysis contributes to these storage lesions.

Methods: Blood bags with CPD-SAGM, stored at 4 °C for 28 days, were withdrawn aseptically on days 1, 14 and 28. Hematology analyzer was used to investigate RBC indices. Hemoglobin oxidation was studied by spectrophotometric scan of spectral change. RBC Lysis was studied by Drabkin’s assay, and morphological changes were observed by light and scan electron microscopy.

Results: Significant changes, RBC shows progressive changes in morphology echinocytes and spherocytes on day 28. There was 0.85% RBC lysis, ~20% decrease in percentage oxyhemoglobin, and a 14% increase in methemoglobin formation shows hemoglobin oxidation on day 28.

Conclusions: Oxidative damage to RBC with an increase in storage time was observed in the present study. The observed morphological changes to RBC during the course of increased time shows that there is progressive damage to RBC membrane and a decrease in hemoglobin concentration, and percentage RBC lysis is probably due to free hemoglobin and iron.


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