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Research opportunities in optimizing storage of red blood cell products

Whether “older” red cells (RBCs) are as efficacious as “younger” RBCs is currently unresolved and awaiting the outcome of several large prospective clinical trials in the US and Canada. In an effort to proactively advance our understanding of the RBC storage lesion prior to the completion of these trials, NHLBI established a targeted research program in 2009 entitled, “Immunomodulatory, Inflammatory and Vasoregulatory Properties of Transfused RBC Units as a Function of Preparation and Storage.” The investigative teams funded by this initiative and their research topics have been previously reported.1 These teams, as well as principle investigators from two of the large prospective clinical RBC storage trials, and other Transfusion Medicine experts gathered on August 28th and 29th, 2012 in Bethesda, MD for an NHLBI sponsored Working Group exploring “Strategies to Optimize Red Blood Cell (RBC) Products.” The first day consisted of progress reports from the eight investigative teams, a presentation about a canine sepsis model to investigate the effect of older blood on survival, and updates from two of the ongoing prospective RBC storage clinical trials. On the second day, researchers provided presentations on a planned study to identify genetic determinants that affect RBC storage, the influence of manufacturing method and irradiation on RBC in vitro quality during storage, development of a new additive solution, the effects of storage containers composition on RBC quality, post collection manipulations, and the possible impact of a reduced RBC shelf life on inventory. This article provides a summary of many of the presentations given during the two-day workshop.