Background: The structural and biochemical changes to erythrocytes during storage, called 'storage lesion', are important factors that contribute to decreases in the efficacy and safety of blood transfusions. However, the biochemical mechanisms are only partly understood.
Study design and methods: Fresh whole blood in citrate phosphate dextrose anticoagulant was preserved in storage bags at 1-4 degrees C for over 20 days. Aliquots of stored blood were withdrawn for analysis at the 1st, 5th, 10th, 15th and 20th day of storage. Whole blood viscosity, plasma reactive carbonyl species, erythrocyte membrane protein carbonylation, protein (tryptophan) fluorescence and the contents of thiols were quantified concurrently.
Results: There were significant increases in blood viscosity and plasma reactive carbonyl species level during storage. There were significant time-dependent increases in membrane protein carbonylation, increases in protein (tryptophan) fluorescence and a decrease in the content of thiols.
Conclusion: Reactive carbonyl species, by attacking the amino and/or sulfhydryl groups of erythrocyte membrane proteins, induce a series of structural alterations in erythrocytes. These lead to an increase in blood viscosity and reduce the efficacy and safety of storage and transfusion.