Contents lists available at ScienceDirect Transfusion and Apheresis Science journal homepage: www.elsevier.com/locate/transci Red cell storage lesion and the effect of buffy-coat reduction on the biochemical parameters Shamee Shastry ⁎ , Aaditya Shivhare, Mohandoss Murugesan, Poornima B. Baliga Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India ARTICLE INFO Keywords: Storage lesion Biochemical changes Metabolic changes Buffy-coat Leukoreduction Hemolysis LDH Plasma hemoglobin Shelf life SAGM CPDA Double bag Triple bag Quadruple bag Red blood cell Quality of RBC ABSTRACT Background: Biochemical and metabolic changes in stored RBC may influence the clinical outcome. We aimed to study the temporal changes in the biochemical parameters and the effect of buffy-coat reduction on RBC storage lesions. Materials and methods: A prospective observational study was conducted on fifteen RBC units five each of buffy coat reduced CPD/SAGM (quadruple bags), non-buffycoat reduced CPD/SAGM (triple bags) and non-buffycoat reduced CPDA (double bags). Biochemical parameters such as K + , LDH, pH plasma hemoglobin and percentage hemolysis were measured sequentially on day 7,14, 21, 28, 35 and 42. The data was analyzed using SPSS version 20. Results: Extracellular K + and LDH increased rapidly starting from the first week of storage. And the all the parameters including percentage hemolysis were significantly higher in RBC stored in CPDA (double bags) compared to that stored in SAGM (triple and quadruple). The difference observed in buffy-coat reduced units in comparison to the non-leukocyte reduced units were statistically not significant. Conclusion: The quality of red cells stored in SAGM was superior to that suspended in CPDA measured in terms of percent hemolysis, plasma hemoglobin, potassium and LDH. There was no effect of buffy-coat leukocyte reduction on the red cell storage lesion. 1. Introduction In vitro storage of RBCs in a liquid medium at lower temperature slows down their metabolism, however metabolic waste, and cellular debris accumulate in the suspending fluid, and the RBCs undergo structural, functional and biochemical alterations. These alterations in RBCs are termed “storage lesions”. These alterations can be extensive and are primarily classified into three broad categories as Biochemical, Biomechanical and Structural changes. These alterations can be ex- tensive and are primarily classified into three broad categories as bio- chemical, biomechanical and structural changes. The biochemical changes within stored RBCs are principally related to alterations in energy metabolism with depletion of 2.3-DPG and ATP. Biomechanical changes involves hemolysis, alteration in deformability, lipid perox- idation, vesiculation, phospholipid conformational changes and al- teration of Na + /K + gradient [1]. As on one hand efforts are being made to discover novel additive solutions extending the shelf life beyond 42 days, there are researchers who propose a benefit of transfusing fresher blood due to the possible deleterious effects of transfusing older units. Several studies are re- ported in the literature on the effect of stored blood on the clinical outcome of the patients. However very few researchers have system- atically analyzed the storage changes in-vitro. In the present study we assessed the temporal changes in various biochemical parameters in stored RBC units and compared the results of leukoreduced units with non-leukoreduced units. 2. Materials and methods A prospective observational study was conducted to measure the changes in biochemical parameters during the storage of P Red Blood Cell units (RBC) in department of immunohematology and blood transfusion. Institutional ethics committee clearance was taken before the commencement of the study. 2.1. RBC unit selection and routine quality assessment Fifteen RBC units five each of buffy coat reduced CPD/SAGM https://doi.org/10.1016/j.transci.2019.01.003 Received 7 July 2018; Received in revised form 14 January 2019; Accepted 31 January 2019 ⁎ Corresponding author. E-mail addresses: shameeshastry@gmail.com (S. Shastry), aadityashivhare@gmail.com (A. Shivhare), mohandossmurugesan@gmail.com (M. Murugesan), baliga.poornima@manipal.edu (P.B. Baliga). Transfusion and Apheresis Science xxx (xxxx) xxx–xxx 1473-0502/ © 2019 Elsevier Ltd. All rights reserved. Please cite this article as: Shamee Shastry, et al., Transfusion and Apheresis Science, https://doi.org/10.1016/j.transci.2019.01.003