What We Did: We analyzed how the quality of leukodepleted stored red blood cells (RBCs) changes over the standard 42-day storage period used in blood banks. We focused on two key indicators of cell integrity—osmotic fragility (OF) and free hemoglobin (fHb)—to determine when stored RBCs begin to lose membrane stability.

What We Found: RBC quality remains relatively stable during the first 28 days of storage, but begins to decline rapidly after this point. After day 28, RBCs showed significantly increased fragility, making them more likely to break under stress.

Why It Matters: Patients with traumatic brain injury (TBI) and other neurocritical conditions rely heavily on optimal oxygen delivery to the brain. If stored RBCs lose stability and deformability after 28 days, transfusions may become less effective precisely when patients need them most. This work highlights the need to consider not only how much blood is transfused, but also the age and quality of the blood unit. Future use of quality markers such as OF may help clinicians personalize transfusion strategies and improve neurological recovery.

+ info