Report on Red Blood Cell Preservation Methods for Blood Transfusion

This report provides a comprehensive overview of red blood cell (RBC) preservation techniques utilized in blood transfusions. It begins by outlining the fundamental biology of RBCs, including their structure, function, and typical range within the body. The report then delves into various preservation methods, such as the use of anticoagulants like EDTA and citrate, as well as additive solutions. It explores cryopreservation techniques and the importance of maintaining hygienic conditions during blood collection. Furthermore, the report discusses pathogen inactivation methods, blood pharming, and the development of blood substitutes. It also addresses the advantages and disadvantages of different preservation techniques and their impact on RBC viability and transfusion outcomes. The report concludes by emphasizing the significance of blood compatibility and the ongoing advancements in the field of blood preservation to improve patient care.

Running head: RED BLOOD CELL PRESERVATION IN TRANSFUSION
Red Blood Cell Preservation In Transfusion
Name of the Student
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Author Note

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RED BLOOD CELL PRESERVATION IN TRANSFUSION
Packed red blood cells are used in blood transfusion. The packed or preserved red
cells are used in the treatment of anemia or when the hemoglobin content of the body falls
below 70-80g/L. The whole blood is collected and twirled in a centrifuge. The red cells are
denser in size and settle down at the bottom of the bag where the blood is stored while the
blood plasma is found to be at the top of the bag (Muller et al., 2015). The red cells are
generally preserved with the help of an additive such as citrate, adenine, and dextrose to keep
the reds live and use for transfusion purposes. The process is usually performed by automated
apheresis, which comprises both mixing and centrifugation at the same time (Matthes et al.,
2014). The blood banks use this technique to reduce the volume of the blood and to use in
various purpose. The primary purpose of the below paper to provide a brief idea about red
blood cell biology and its preservation methods that are used in a transfusion.
Red blood cells are oxygen and carbon dioxide carrying cells in the body throughout
the blood. This comprises of hemoglobin which is a pigment of blood responsible for
providing the red color of RBC. It is also known as erythrocytes or red corpuscles. The usual
range of RBC in the body is 4.2-5.9 cells/cm. It is responsible for taking up oxygen from the
lungs and release it into the tissues. The cytoplasm of the erythrocytes is generally abundant
in iron-containing biomolecules called hemoglobin. The cell membrane consists of lipid and
protein, which is essential for maintaining stability and maintaining the capillary network.
The mature red cells are oral biconcave in shape, which lacks a true nucleus for
accommodating more amount of hemoglobin. The cells are formed in the bone marrow and
are circulated throughout the body before it is recovered by macrophages (Barbalato &
Pillarisetty, 2019). The transfusion is a process where blood from a donor is transferred into
the receipt body after the proper screening to reduce the chance of blood-borne disease. The
blood group is tested previously before transfusion to reduce the chance of acute hemolytic
transfusion or reaction (Harewood & Master, 2019).

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In the earlier days, blood is preserved with the help of disodium
ethylenediaminetetraacetate. It is regarded as a potent anticoagulant for blood which
conserves the cellular elements and is excreted by the body and also in toxic (Cieplinski et
al., 2019). It was used for the preservation of blood for three weeks to four weeks. The
preservation is also combined with the agents such as raffinose and glucose, which in turn
proliferations the persistence time of the erythrocytes from four weeks to six weeks. It is a
complete atoxic method of preservation. The ethyl alcohol saline sugar solution also helps in
preserving the red blood cells for about 150days. It is notable for preserving the agglutinogen
for a more extended period of time. The whole blood is usually preserved with the help of
glycerine-raffinose glucose and is usually kept at a temperature of -20 degrees centigrade.
This process can preserve blood upto two months or more without even hemolysis of blood.
Another method that was used in blood preservation is multiple plastic bag system which
consists of additives solution. It gave a positive result where the lifespan of the red cells
increased up to 42 to 49 days, and it also decreased the number of contaminants in the blood,
such as leukocytes, thrombocytes, platelets. ACD- A anticoagulant Citrate Dextrose is a non-
pyrogenic sterile solution used in the preservation of blood (Gyorgy et al., 2014). It is used in
the production of platelet-rich plasma in the process of extracorporeal blood dispensation
with the Autologous PRP system. It preserves the blood for about 21 days, and the survival
rate in vivo was 70 percent. The chronology of anticoagulants is citrate dextrose, acid
dextrose, phosphate dextrose, added nucleotide, CPDA1, Additive solution, SAG, and CP2D.
Cryopreservation is one of the vital techniques in preserving the cells, which also maintains
the structure and function of the cells. The cryoprotectants that are used to preserve are
glycerol, DMSO (Li et al., 2020).
The blood cells are collected in hematology laboratory or blood banks with the help of
venepuncture and vacutainers. The venepuncture method has some guidelines which help in

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reducing the infection. The equipment must be maintained and calibrated. The blood
equipment includes scales, blood pressure monitors, blood collection monitors, blood bag
tube, refrigerators, and mixers. It is essential in any collection process to maintain a hygienic
condition. The equipment is disinfected with sodium hypochlorite soluble, which restricts the
development of the pathogenic microorganisms. Another critical system in the collection
process is a bag containing anticoagulant. It is integrated with a tube and needle. The bags
also contain a system of the sequester, which is helpful in minimizing the contamination of
bacteria. The steps that are followed in the venepuncture collection system are donor
identification, selection of vein, disinfecting the skin, venepuncture by needle, monitoring the
unit, and finally, sample collection (Oladeinde et al., 2017).
The blood sample is preserved mainly in the refrigerator; the frozen state is avoided to
minimize the chance lysis. The cells are preserved by the help of anticoagulants such as
EDTA; it preserves the cells by chelating the calcium ions and prevents the clotting. The
citrate also chelates the calcium ion and prevents the clotting. The anticoagulants act by
suppressing the synthesis of clotting factors present in the body (Shabnam et al., 2014).
The improved additive that is used in the preservation of blood is saline-adenine-
glucose-mannitol. It consists of phosphate and citrate and provides optimum cell viability.
The components present in this additive perform a different function, such as isotonicity is
provided by sodium chloride, ATP is maintained by adenine, glucose promotes nutrition and
metabolism, and lysis is reduced by mannitol. The CP2D is used along with an additive
solution AS3, which does not contain glucose. The additive solutions gave an extreme
recovery of plasma and preparation of the RBC unit.
The pathogen inactivation in blood samples is done by Solvent/Detergent, which
works by disrupting the membrane of the pathogen. It consists of an organic solvent and a

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non-ionic detergent. The THERAFLEX MB-Plasma system is used in removing pathogens
with the help of filtration, 630nm light for inactivation of the pathogen, and methylene blue.
This system deactivates the nucleic acid present in the pathogen. Other techniques are the
INTERCEPT blood system, which breaks the forms of the non-covalent bond in the nucleus
and blocks the RNA transcription (Seltsam, 2017). The blood compatibility is essential in
blood transfusion. The O type patient is compatible with only O type red cells. The plasma
compatibility of this group is O, A, B, and AB.
Blood pharming is a technique of producing red blood cells and its safe, readily
available for a prolonged purpose. It is used in the development of cell culture in an
automated amount, which is useful in transferring cells as universal donors. The erythrocytes
are produced by human progenitor cells, which is regarded as a starting material. It has
oxygen-carrying capacity, morphology, and characteristics. The system had a capacity to
purify the end products that are associated with transfusion (Gollomp, Lambert & Poncz,
2017).
There are different types of blood substitutes that are developed in recent years, such
as perfluorochemical which are insoluble in the liquid phase, it dissolves more amount of
carbon dioxide, it is also a non-toxic, inert, colorless substance with better oxygen-carrying
carrying capacity. The next type is Hb-based RBC substitutes; it is the primary source of Hb
production; it has many advantages such as reduction of infection, better oxygen-carrying
capacity, and low binding with nitric oxide. Recombinant Hb is another form that is regarded
as the most developed form of Hb as it has a greater half-life and decreased complication
(Moradi et al., 2016).
The disadvantage of additives such as SAG and CP2D solution is it fails to maintain a
2,3 DPG during the storage time, and therefore it is not recommended for children. The

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THERAFLEX MB-Plasma system is still developing for reducing the virus range in the
blood, and also development is needed for illumination range. As the viruses with low light
sensitivity fail to get inactivate. INTERCEPT blood system reduces the functional stability
and half-life of platelets. The blood hemoglobin produced from the blood pharming
technique gives rise to many diseases such as trauma due to replacement, promotes rapid
blood loss from the blood, promotes cardiovascular diseases due to blood clots and also
sometimes develops blood cancer. The limitation of recombinant Hb is its instability in the
vector. It also lacks some vital proteins, the globin and, most importantly, the prosthetic
group, which is highly essential for maintaining stability and function. Blood substitutes such
as perfluorochemical may lead to the development of neurological problems along with
cancers, especially in the liver.
The above paper discussed the packed blood cells, which is essential in blood
transfusion. The red cells are responsible for carrying oxygen, which thereby supplies in all
the organs. The preservation technique, such as anticoagulants like glycerine-raffinose
glucose, cryopreservation with cryoprotectant DMSO and glycerol, additive solutions such as
SAG-M, AS3 helps in increasing the ATP level of the blood cells along with cell viability.
The pathogen inactivation techniques like solvent/detergent, THERAFLEX MB-Plasma
system helps in reducing or damaging the disease-causing pathogen in blood. The paper also
focuses on the blood pharming technique and blood substitutes, as it increased the availability
and functionality of the erythrocytes. Lastly, the paper discusses the disadvantages of
techniques.

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