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Rahimi Sabet Z, Ghobeh M, Khorshidfar M, Deyhim M R. Comparative Analysis of Oxidative Damage and Metabolic Parameters in Red Blood Cells Stored in CPDA1 and CPD+SAGM. bloodj 2025; 22 (2) :123-136
URL: http://bloodjournal.ir/article-1-1578-en.html
Comparative Analysis of Oxidative Damage and Metabolic Parameters in Red Blood Cells Stored in CPDA1 and CPD+SAGM
Zahra Rahimi Sabet , Maryam Ghobeh , Mona Khorshidfar , Mohammad Reza Deyhim *
Keywords: Red Blood Cells, Blood Banking, Oxidative Damage
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References:
  1. Tinmouth A, Chin-Yee I. The clinical consequences of the red cell storage lesion. Transfus Med Rev 2001; 15(2): 91-107. https://doi.org/10.1053/tm.2001.22613 [DOI:10.1053/tmrv.2001.22613]
  2. Chaudhary R, Katharia R. Oxidative injury as contributory factor for red cells storage lesion during twenty eight days of storage. Blood Transfus 2012; 10(1): 59-62
  3. Olechnowicz J, Tinkov A, Skalny A, Suliburska J. Zinc status is associated with inflammation, oxidative stress, lipid, and glucose metabolism. J Physiol Sci 2018; 68(1): 19-31. [DOI:10.1007/s12576-017-0571-7] [PMID] []
  4. Hashemi Tayer A, Amirizadeh N, Mghsodlu M, Nikogoftar M, Deyhim MR, Ahmadinejad M. Evaluation of Blood Storage Lesions in Leuko-depleted Red Blood Cell Units. Iran J Ped Hematol Oncol 2017; 7 (3):171-9. [Article in Farsi]
  5. Jahanshahi Ghajar S, Deyhim MR, Sotoudehnejad  Nematollahi F,  Rafiei  MH.  Red blood cells storage lesion: the effect of blood donation time on biochemical parameters. Sci J Iran Blood Transfus Organ 2019; 16 (3): 161-71. [ Article in Farsi]
  1. Shastry S, Shivhare A, Murugesan M, Baliga PB. Red cell storage lesion and the effect of buffy-coat reduction on the biochemical parameters. Transfus Apher Sci 2019; 58(2): 179-82. [DOI:10.1016/j.transci.2019.01.003] [PMID]
  2. Verma M, Dahiya K, Malik D, Sehgal P, Devi R, Soni A, et al. Effect of blood storage on complete biochemistry. J Blood Disord Transfus 2015; 6(6): 1-4. [DOI:10.4172/2155-9864.1000329]
  3. Charles AT, Bungudu UG, Osaro E, Tosan E. Effect of Storage on Osmotic Fragility in CPDA-1 Stored Blood in Sokoto, Northwestern Nigeria. Advances in Hematology and Oncology Research 2018; 1(1): 1-6. [DOI:10.33140/AHOR.01.01.02]
  4. Reval D , Sharma R, Lodha S, Prakash S. Biochemical Changes in the Stored Whole Blood Assessd at the Pediatric Intervalsin CPDA1 Anticoagulant Containing Blood Bags. Asian J Pharm Clin Res 2023; 16(2): 113-5. [DOI:10.22159/ajpcr.2023.v16i2.47220]
  5. Van Wijk R, Van Solinge WW. The energy-less red blood cell is lost: erythrocyte enzyme abnormalities of glycolysis. Blood 2005; 106(13): 4034-42. [DOI:10.1182/blood-2005-04-1622] [PMID]
  6. Danehpash S, Shirkhanloo H, Azami K, Deyhim MR. Evaluation of Lipid Peroxidation, Antioxidant Status and Trace Elements in Red Blood Cell Concentrates during Storage. Iranian Jurnal of Blood and Cancer 2021; 13(3): 85-91
  7. Ghezelbash B, Azarkeivan A, Pourfathollah AA, Deyhim M, Hajati E, Goodarzi A. Comparative Evaluation of Biochemical and Hematological Parameters of Pre-Storage Leukoreduction during RBC Storage. Int J Hematol Oncol Stem Cell Res 2018; 12(1): 35-42.
  8. Mustafa I, Al Marwani A, Mamdouh Nasr K, Abdulla Kano N, Hadwan T. Time dependent assessment of morphological changes: leukodepleted packed red blood cells stored in SAGM. Biomed Res Int 2016; 2016: 4529434. [DOI:10.1155/2016/4529434] [PMID] []
  9. Orlov D, Karkouti K. The pathophysiology and consequences of red blood cell storage. Anaesthesia 2015; 70(1): 29-37. [DOI:10.1111/anae.12891] [PMID]
  10. Kücükakin B, Kocak V, Lykkesfeldt J, Nielsen HJ, Magnussen K, Rosenberg J, et al. Storage-induced increase in biomarkers of oxidative stress and inflammation in red blood cell components. Scand J Clin Lab Invest 2011; 71(4): 299-303. [DOI:10.3109/00365513.2011.563789] [PMID]
  11. Aggarwal G, Tiwari AK, Pabbi S, Bhardwaj G, Rawat G, Harith AK, et al. Storage Lesions in Red Blood Cell‐Saline Adenine Glucose Mannitol: In-vitro and In-vivo Analysis over 42 Days and its Implications in Routine Transfusion Practice. Global Journal of Transfusion Medicine 2022; 7(1): 12-7. [DOI:10.4103/gjtm.gjtm_113_20]
  12. Nguyen T , Fernández C, Pastora J. Impact of Different Red Blood Cell Storage Solutions and Conditions on Cell Function and Viability: A Systematic Review. Biomolecule 2024; 14(813): 1-28 [DOI:10.3390/biom14070813] [PMID] []
  13. Omidkhoda A, Hedayati B, Kafi-Abad SA. The effect of whole blood storage time  on  quality  of
    RBCs. Scientific Journal of Iranian Blood  Transfusion Organization. Sci J Iran Blood Transfus Organ 2015, 11(1): 56-63. [Article in Farsi]
  14. Mukherjee S, Marwaha N, Prasad R, Sharma RR, Thakral B. Serial assessment of biochemical parameters of red cell preparations to evaluate safety for neonatal transfusions. Indian J Med Res 2010; 132: 715-20.
  15. Marjani A, Abolvahab Moradi A, Araz Berdie Ghourcaie A.B. Alterations in Plasma Lipid Peroxidation and Erythrocyte Superoxide Dismutase and Glutathione Peroxidase Enzyme Activities During Storage of Blood. Asian Journal of Biochemistry 2007; 2(2): 118-23. [DOI:10.3923/ajb.2007.118.123]
  16. Deyhim MR, Nabavi Z, Jalili MA, Maghsoudloo M, Khoshnaghsh F. Alternation in Erythrocyte Enzyme Antioxidant Activity during Blood Storage. Iranian Journal of Blood and Cancer 2014; 6(2): 69-74.
  17. Wilking M, Ndiaye M, Mukhtar H, Ahmad N. Circadian Rhythm Connections to Oxidative Stress: Implications for Human Health. Antioxid Redox Signal 2013; 19(2): 192-208. [DOI:10.1089/ars.2012.4889] [PMID] []
  18. Barzegar S, Nadali F, Pourfatollah A.A, Abbaspour A.R, Farokhinia S, Shiravand Y. Oxidative stress changes in blood bags in consecutive weeks after donation. Sci J Iran Blood Transfus Organ 2016, 13(1): 11-8. [Article in Farsi]
  19. Saeideh Hajizamani, Kamran Atarodi, Mohammad Reza Deyhim, Fahimeh Ranjbar Kermani, Kamran Mousavi Hosseini. Antioxidative effects of α‑tocopherol on stored human red blood cell units. Asian J Transfus Sci 2024; 18(1): 102-7. [DOI:10.4103/ajts.ajts_130_22] [PMID] []
  20. Mehrdadi N, Deyhim M.R, Hekmat A. The effect of N-acetyl-cysteine (NAC) on RBC oxidative damage and RBC metabolism during storage of red blood cell product in blood bank condition. Medical Journal of Tabriz University of Medical Sciences and Health Services 2021; 42(6): 667-76. [Article in Farsi] [DOI:10.34172/mj.2021.007]




Comparative Analysis of Oxidative Damage and Metabolic Parameters in Red Blood Cells Stored in CPDA1 and CPD+SAGM


‎Zahra Rahimi Sabet1, Maryam Ghobeh1     , Mona Khorshifar2       , Mohammad Reza Deyhim3    


1Faculty of Basic Sciences, Islamic Azad University, Science and Research Branch, Tehran, Iran
2UBC Center Heart Lung Innovation, British Colombia, Canada, Vancouver
3Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran

Received: 2025/04/15
Accepted: 2025/0610
 





    https://doi.org/10.18502/avr.v34i2.18052
    



Citation:
Rahimi Sabet Z, Ghobeh M, Khorshidfar M, Deyhim M.R. Comparative Analysis of Oxidative Damage and Metabolic Parameters in Red Blood Cells Stored in CPDA1 and CPD+SAGM. J Iran Blood Transfuse. 2025: 22 (2): 123-136
    



Correspondence: Deyhim M.R., Assistant Professor of Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine.
P.O.Box: 14665-1157, Tehran, Iran.
Tel: (+9821) 82052180
E-mail: m.deyhim@tmi.ac.ir           
 		 A B S T R A C T
Background and Objectives
During storage, Red Blood Cells (RBCs) undergo a series of morphological and functional changes that diminish their survival and function, and collectively are known as Red Blood Cell storage lesion. Oxidative damage and metabolic changes in RBCs are the main causes of this lesion. This study aimed to evaluate RBC storage lesion using oxidative and metabolic parameters in two distinct preservation systems: CPDA1 and CPD combined with SAGM.
Materials and Methods
In this experimental study, carried out at the Blood Transfusion Research Center, five RBC units containing CPDA1 and five with CPD+SAGM were selected through simple random sampling. Oxidative and metabolic parameters were evaluated over a 42-day storage period, with evaluations conducted on days 0, 2, 7, 14, 21, 28, 35, and 42. For each sampling point, parameter measurements were performed in duplicate. Independent t-tests and Mann-Whitney tests were used to compare variables at each time between groups. A two-way variance test with repeated measures was employed point to evaluate the trend of changes within the group over time.
Results
The findings indicated that the activity of lactate dehydrogenase (LDH) and the concentration of lactate exhibited a markedly lower increase in the CPD+SAGM group compared to the CPDA1 group (p<0.05). Furthermore, the glucose concentration and pH exhibited a less reduction in the CPD+SAGM group than in the CPDA1 group (p<0.05). In a pairwise group, comparison of malondialdehyde (MDA) and total oxidant concentration showed a less increase in the CPD+SAGM group when compared to the CPDA1 group across various days of RBC storage, particularly from the day 7 onward (p<0.05).
Conclusions 
The results of this study showed that SAGM more effectively mitigates the RBC storage lesion compared to CPDA1 by maintaining metabolic activity and reducing oxidative damage. This may contribute to better preservation of RBC survival and improvement of the quality during storage. However, further studies are required at both in vitro and in vivo levels.
Key words: Red Blood Cells, Blood Banking, Oxidative Damage
 
Copyright © 2025 Journal of Iranian Blood Transfusion, Published by Blood Transfusion Research Center.
This work is licensed under a Creative Common Attribution-Non Commercial 4.0 International license.




1- Acridine Orange
1- Biological safety cabinet
1- Platelet Concentrate
2- Food and Drug Administration
3- Normal Skin Flora
4- Platelet Rich Plasma-Platelet Concentrate
5- Eosin-Methylene blue
6- Thioglycolate
1- Acridine Orange
1- Biological safety cabinet
1- Platelet Concentrate
2- Food and Drug Administration
3- Normal Skin Flora
4- Platelet Rich Plasma-Platelet Concentrate
5- Eosin-Methylene blue
6- Thioglycolate

1- Acridine Orange
1- Biological safety cabinet
1- Platelet Concentrate
2- Food and Drug Administration
3- Normal Skin Flora
4- Platelet Rich Plasma-Platelet Concentrate
5- Eosin-Methylene blue
6- Thioglycolate
1- Acridine Orange
1- Biological safety cabinet
1- Platelet Concentrate
2- Food and Drug Administration
3- Normal Skin Flora
4- Platelet Rich Plasma-Platelet Concentrate
5- Eosin-Methylene blue
6- Thioglycolate

 
Type of Study: Research | Subject: Biochemistry
References
1. Tinmouth A, Chin-Yee I. The clinical consequences of the red cell storage lesion. Transfus Med Rev 2001; 15(2): 91-107. https://doi.org/10.1053/tm.2001.22613 [DOI:10.1053/tmrv.2001.22613]
2. Chaudhary R, Katharia R. Oxidative injury as contributory factor for red cells storage lesion during twenty eight days of storage. Blood Transfus 2012; 10(1): 59-62
3. Olechnowicz J, Tinkov A, Skalny A, Suliburska J. Zinc status is associated with inflammation, oxidative stress, lipid, and glucose metabolism. J Physiol Sci 2018; 68(1): 19-31. [DOI:10.1007/s12576-017-0571-7] [PMID] []
4. Hashemi Tayer A, Amirizadeh N, Mghsodlu M, Nikogoftar M, Deyhim MR, Ahmadinejad M. Evaluation of Blood Storage Lesions in Leuko-depleted Red Blood Cell Units. Iran J Ped Hematol Oncol 2017; 7 (3):171-9. [Article in Farsi]
5. Jahanshahi Ghajar S, Deyhim MR, Sotoudehnejad Nematollahi F, Rafiei MH. Red blood cells storage lesion: the effect of blood donation time on biochemical parameters. Sci J Iran Blood Transfus Organ 2019; 16 (3): 161-71. [ Article in Farsi]
6. Shastry S, Shivhare A, Murugesan M, Baliga PB. Red cell storage lesion and the effect of buffy-coat reduction on the biochemical parameters. Transfus Apher Sci 2019; 58(2): 179-82. [DOI:10.1016/j.transci.2019.01.003] [PMID]
7. Verma M, Dahiya K, Malik D, Sehgal P, Devi R, Soni A, et al. Effect of blood storage on complete biochemistry. J Blood Disord Transfus 2015; 6(6): 1-4. [DOI:10.4172/2155-9864.1000329]
8. Charles AT, Bungudu UG, Osaro E, Tosan E. Effect of Storage on Osmotic Fragility in CPDA-1 Stored Blood in Sokoto, Northwestern Nigeria. Advances in Hematology and Oncology Research 2018; 1(1): 1-6. [DOI:10.33140/AHOR.01.01.02]
9. Reval D , Sharma R, Lodha S, Prakash S. Biochemical Changes in the Stored Whole Blood Assessd at the Pediatric Intervalsin CPDA1 Anticoagulant Containing Blood Bags. Asian J Pharm Clin Res 2023; 16(2): 113-5. [DOI:10.22159/ajpcr.2023.v16i2.47220]
10. Van Wijk R, Van Solinge WW. The energy-less red blood cell is lost: erythrocyte enzyme abnormalities of glycolysis. Blood 2005; 106(13): 4034-42. [DOI:10.1182/blood-2005-04-1622] [PMID]
11. Danehpash S, Shirkhanloo H, Azami K, Deyhim MR. Evaluation of Lipid Peroxidation, Antioxidant Status and Trace Elements in Red Blood Cell Concentrates during Storage. Iranian Jurnal of Blood and Cancer 2021; 13(3): 85-91
12. Ghezelbash B, Azarkeivan A, Pourfathollah AA, Deyhim M, Hajati E, Goodarzi A. Comparative Evaluation of Biochemical and Hematological Parameters of Pre-Storage Leukoreduction during RBC Storage. Int J Hematol Oncol Stem Cell Res 2018; 12(1): 35-42.
13. Mustafa I, Al Marwani A, Mamdouh Nasr K, Abdulla Kano N, Hadwan T. Time dependent assessment of morphological changes: leukodepleted packed red blood cells stored in SAGM. Biomed Res Int 2016; 2016: 4529434. [DOI:10.1155/2016/4529434] [PMID] []
14. Orlov D, Karkouti K. The pathophysiology and consequences of red blood cell storage. Anaesthesia 2015; 70(1): 29-37. [DOI:10.1111/anae.12891] [PMID]
15. Kücükakin B, Kocak V, Lykkesfeldt J, Nielsen HJ, Magnussen K, Rosenberg J, et al. Storage-induced increase in biomarkers of oxidative stress and inflammation in red blood cell components. Scand J Clin Lab Invest 2011; 71(4): 299-303. [DOI:10.3109/00365513.2011.563789] [PMID]
16. Aggarwal G, Tiwari AK, Pabbi S, Bhardwaj G, Rawat G, Harith AK, et al. Storage Lesions in Red Blood Cell‐Saline Adenine Glucose Mannitol: In-vitro and In-vivo Analysis over 42 Days and its Implications in Routine Transfusion Practice. Global Journal of Transfusion Medicine 2022; 7(1): 12-7. [DOI:10.4103/gjtm.gjtm_113_20]
17. Nguyen T , Fernández C, Pastora J. Impact of Different Red Blood Cell Storage Solutions and Conditions on Cell Function and Viability: A Systematic Review. Biomolecule 2024; 14(813): 1-28 [DOI:10.3390/biom14070813] [PMID] []
18. Omidkhoda A, Hedayati B, Kafi-Abad SA. The effect of whole blood storage time on quality of RBCs. Scientific Journal of Iranian Blood Transfusion Organization. Sci J Iran Blood Transfus Organ 2015, 11(1): 56-63. [Article in Farsi]
19. Mukherjee S, Marwaha N, Prasad R, Sharma RR, Thakral B. Serial assessment of biochemical parameters of red cell preparations to evaluate safety for neonatal transfusions. Indian J Med Res 2010; 132: 715-20.
20. Marjani A, Abolvahab Moradi A, Araz Berdie Ghourcaie A.B. Alterations in Plasma Lipid Peroxidation and Erythrocyte Superoxide Dismutase and Glutathione Peroxidase Enzyme Activities During Storage of Blood. Asian Journal of Biochemistry 2007; 2(2): 118-23. [DOI:10.3923/ajb.2007.118.123]
21. Deyhim MR, Nabavi Z, Jalili MA, Maghsoudloo M, Khoshnaghsh F. Alternation in Erythrocyte Enzyme Antioxidant Activity during Blood Storage. Iranian Journal of Blood and Cancer 2014; 6(2): 69-74.
22. Wilking M, Ndiaye M, Mukhtar H, Ahmad N. Circadian Rhythm Connections to Oxidative Stress: Implications for Human Health. Antioxid Redox Signal 2013; 19(2): 192-208. [DOI:10.1089/ars.2012.4889] [PMID] []
23. Barzegar S, Nadali F, Pourfatollah A.A, Abbaspour A.R, Farokhinia S, Shiravand Y. Oxidative stress changes in blood bags in consecutive weeks after donation. Sci J Iran Blood Transfus Organ 2016, 13(1): 11-8. [Article in Farsi]
24. Saeideh Hajizamani, Kamran Atarodi, Mohammad Reza Deyhim, Fahimeh Ranjbar Kermani, Kamran Mousavi Hosseini. Antioxidative effects of α‑tocopherol on stored human red blood cell units. Asian J Transfus Sci 2024; 18(1): 102-7. [DOI:10.4103/ajts.ajts_130_22] [PMID] []
25. Mehrdadi N, Deyhim M.R, Hekmat A. The effect of N-acetyl-cysteine (NAC) on RBC oxidative damage and RBC metabolism during storage of red blood cell product in blood bank condition. Medical Journal of Tabriz University of Medical Sciences and Health Services 2021; 42(6): 667-76. [Article in Farsi] [DOI:10.34172/mj.2021.007]
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