Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hematol. Nov 6, 2015; 4(4): 54-68
Published online Nov 6, 2015. doi: 10.5315/wjh.v4.i4.54
Storage lesion: History and perspectives
Julien Delobel, Olivier Garraud, Stefano Barelli, Jean-Jacques Lefrère, Michel Prudent, Niels Lion, Jean-Daniel Tissot
Julien Delobel, Stefano Barelli, Michel Prudent, Niels Lion, Jean-Daniel Tissot, Transfusion Interrégionale CRS, 1066 Lausanne, Switzerland
Olivier Garraud, Jean-Jacques Lefrère, Institut National de Transfusion Sanguine, 75739 Paris, France
Olivier Garraud, Faculty of Medicine, University of Lyon Saint-Etienne, 69007 Lyon, France
Author contributions: Delobel J and Tissot JD wrote the review; Garraud O, Barelli S, Prudent M and Lion N wrote different parts of the paper; Lefrère JJ, before dying, gave us many historical information used in the paper.
Supported by The Commission de Recherche du Service de Transfusion Sanguine de la Croix Rouge suisse and the CETRASA.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Jean-Daniel Tissot, Professor, Transfusion Interrégionale CRS, Route de la Corniche 2, 1066 Epalinges, Switzerland.
Telephone: +41-21-3146589 Fax: +41-21-3146578
Received: July 2, 2015
Peer-review started: July 9, 2015
First decision: August 25, 2015
Revised: September 15, 2015
Accepted: October 16, 2015
Article in press: October 19, 2015
Published online: November 6, 2015

Red blood cell concentrates (RBCCs) are the major labile blood component transfused worldwide to rescue severe anemia symptoms. RBCCs are frequently stored in additive solutions at 4 °C for up to 42 d, which induces cellular lesion and alters red blood cell metabolism, protein content, and rheological properties. There exists a hot debate surrounding the impact of storage lesion, with some uncertainty regarding how RBCC age may impact transfusion-related adverse clinical outcomes. Several studies show a tendency for poorer outcomes to occur in patients receiving older blood products; however, no clear significant association has yet been demonstrated. Some age-related RBCC alterations prove reversible, while other changes are irreversible following protein oxidation. It is likely that any irreversible damage affects the blood component quality and thus the transfusion efficiency. The present paper aims to promote a better understanding of the occurrence of red blood cell storage lesion, with particular focus on biochemical changes and microvesiculation, through a discussion of the historical advancement of blood transfusion processes.

Keywords: Ageing, Blood cells, Exosomes, Microparticles, Microvesicles, Proteomics, Storage, Transfusion

Core tip: This review paper puts in perspective the red blood cell storage lesion, which is a hot topic in transfusion medicine. Many different physiological and biochemical pathways are affected by cold storage, and stored red blood cells are clearly very different when compared to freshly drown erythrocytes. However, most of clinicians are lost in translation because experimental data and clinical data are divergent. Therefore, both fundamental, translational and clinical studies are needed in the near future to provide better care to our patients.