Time dependent changes in red blood cells during storage in the local blood banks of Khyber Pakhtunkhwa

Supplementary Files




Objective: This project aimed at determining time-dependent ultrastructural and hematological changes taking place in blood stored in local blood banks of Khyber Pakhtunkhwa.

Methods: It was a longitudinal study with repeated measures design. Twenty healthy blood donors participated in this study. An amount of 250ml blood was collected from each donor and stored in Citrate Phosphate Dextrose Adenine-1 (CPDA-1)-containing blood bags. Within first four hours, baseline samples were taken while subsequent samples were obtained at 5 days interval till day 20 th . Structural changes in RBCs were observed under light and scanning electron microscope (SEM) at different intervals. Furthermore, hematological parameters and osmotic fragility were also determined.

Results: Remarkable alterations were seen in RBCs morphology. From 5th day onwards, multiple visible spicules were observed on the RBC’s outer membrane and more than 2/3rd cells were abnormal at day 20. There was a significant reduction in RBCs count and hemoglobin concentration while the remaining parameters remained unchanged. Osmotic fragility increased significantly over time, with <1% haemolysis noted in baseline samples as compared to 2.4% haemolysis on day 20th (p?0.0001).

Conclusion: Prolonged storage of blood results in distorted RBCs morphology and increased fragility. Transfusion of such cells would potentially result in rapid lysis in patients with hepatosplenomegaly and conditions requiring multiple blood transfusions.

Keywords: Red cells storage, scanning electron microscope, osmotic fragility, Transfusion, Blood storage, hemoglobin.