Department of Chemical Engineering, Texas Tech University, Lubbock, TX 79409, USA.
Chemical and Biomolecular Engineering Department, Universidad de Cantabria, Avda. Los Castros, s/n, 39005 Santander, Spain.
Biomolecules. 2024 Jul 8;14(7):813. doi: 10.3390/biom14070813.
Red blood cell (RBC) storage solutions have evolved significantly over the past decades to optimize the preservation of cell viability and functionality during hypothermic storage. This comprehensive review provides an in-depth analysis of the effects of various storage solutions and conditions on critical RBC parameters during refrigerated preservation. A wide range of solutions, from basic formulations such as phosphate-buffered saline (PBS), to advanced additive solutions (ASs), like AS-7 and phosphate, adenine, glucose, guanosine, saline, and mannitol (PAGGSM), are systematically compared in terms of their ability to maintain key indicators of RBC integrity, including adenosine triphosphate (ATP) levels, morphology, and hemolysis. Optimal RBC storage requires a delicate balance of pH buffering, metabolic support, oxidative damage prevention, and osmotic regulation. While the latest alkaline solutions enable up to 8 weeks of storage, some degree of metabolic and morphological deterioration remains inevitable. The impacts of critical storage conditions, such as the holding temperature, oxygenation, anticoagulants, irradiation, and processing methods, on the accumulation of storage lesions are also thoroughly investigated. Personalized RBC storage solutions, tailored to individual donor characteristics, represent a promising avenue for minimizing storage lesions and enhancing transfusion outcomes. Further research integrating omics profiling with customized preservation media is necessary to maximize post-transfusion RBC survival and functions. The continued optimization of RBC storage practices will not only enhance transfusion efficacy but also enable blood banking to better meet evolving clinical needs.
红细胞（RBC）储存液在过去几十年中得到了显著发展，以优化低温储存过程中细胞活力和功能的保存。本综述深入分析了各种储存液和储存条件对冷藏保存过程中关键 RBC 参数的影响。广泛的储存液，从基础配方如磷酸盐缓冲盐水（PBS），到先进的添加剂溶液（AS），如 AS-7 和磷酸盐、腺嘌呤、葡萄糖、鸟嘌呤、盐水和甘露醇（PAGGSM），都在冷藏保存过程中维持 RBC 完整性的关键指标，包括三磷酸腺苷（ATP）水平、形态和溶血等方面进行了系统比较。最佳 RBC 储存需要精细平衡 pH 缓冲、代谢支持、氧化损伤预防和渗透调节。虽然最新的碱性储存液可以支持长达 8 周的储存，但代谢和形态恶化仍不可避免。还彻底研究了关键储存条件（如保存温度、氧合、抗凝剂、辐照和处理方法）对储存损伤积累的影响。针对个体供体特征定制 RBC 储存液代表了一种有前途的方法，可以最大限度地减少储存损伤并提高输血效果。将组学分析与定制保存液相结合的进一步研究对于最大限度地提高输血后 RBC 的存活率和功能非常必要。继续优化 RBC 储存实践不仅可以提高输血效果，还可以使血库更好地满足不断发展的临床需求。
