Effect of Red Cell Concentrate Storage on Electrolyte Levels and Hematological Parameters
DOI:
https://doi.org/10.51253/pafmj.v76iSUPPL-8.13909Keywords:
Blood transfusion, Citrate-Phosphate-Dextrose-Adenine triple bag, Electrolytes, Mean corpuscular volume (MCV), Red cell concentrate (RCC).Abstract
Objective: To observe the changes in Electrolyte levels and Hematological Parameters in Stored Red Cell Concentrate (RCC).
Study Design: Analytical Cross-Sectional Study.
Place and Duration of Study: Blood Bank and Department of Pathology, Combined Military Hospital, Multan, Pakistan, from Jan to Aug 2025.
Methodology: Stored RCC units prepared from healthy voluntary blood donors and stored under standard blood bank conditions (2–6°C) in CPDA-1 triple bags were selected for study. One hundred and fifty RCC units were sampled, and a 5 mL sample was aseptically withdrawn from each RCC unit on the donation day, 20th and 35th days. Electrolyte parameters, including potassium, sodium, calcium, and chloride, along with pH and Hematological parameters such as mean corpuscular volume (MCV) and red cell count, were measured, and the trend of change was compared between all three samples from designated bags.
Results: RBC count demonstrated 11.4% decline with median RBC 4.88(0.66)×10⁹/L on Day-1 to 4.32(1.15)×10⁹/L by Day-35 (p<0.001). In contrast, MCV increased 8.8%, from median 84.50(14.00) fL on Day-1 to 92.00(10.00) fL on Day-35 (p<0.001). Sodium decreased 3.8% from 142.00(2.85) mmol/L on Day-1 to 136.52(1.46) mmol/L on Day-35 and Potassium increased markedly 248.1% from median 4.03(0.85) mmol/L on Day-1, to 14.03(0.94) mmol/L on Day-35 (p<0.001). Calcium and Chloride levels showed 7.5% and 18.3% decrease respectively, whereas pH decreased 6% from 7.43(0.67) on Day-1 to 6.98(0.60) on Day-35 (p<0.001).
Conclusion: There were significant hematological and biochemical alterations in RCC during storage, proportional to the duration of the stored RCC bag.
Downloads
References
1. Javed SO, Saleem A, Sahito AM, Hasan MM. Transfusion Transmitted Infections: A Present-Day Danger for Pakistan. Am J Trop Med Hyg 2022; 106(5): 1311–1314.
https://doi.org/10.4269/ajtmh.21-1136
2. Al-Thani AM, Voss SC, Al-Menhali AS, Barcaru A, Horvatovich P, Al Jaber H, et al. Whole Blood Storage in CPDA1 Blood Bags Alters Erythrocyte Membrane Proteome. Oxid Med Cell Longev 2018; 2018: 6375379. https://doi.org/10.1155/2018/6375379
3. Alayash AI. Hemoglobin Oxidation Reactions in Stored Blood. Antioxidants 2022; 11(4): 747.
https://doi.org/10.3390/antiox11040747
4. Suryanto S, Gugun A, Nurpratami D. The Difference in Potassium Levels In Fresh Blood Bags With Blood Bags Stored At PKU Muhammadiyah Gamping Hospital. Cerdika: Jurnal Ilmiah Indonesia 2024; 4(2): 183–190.
https://doi.org/10.59141/cerdika.v4i2.758
5. Oyet C, Okongo B, Onyuthi RA, Muwanguzi E. Biochemical changes in stored donor units: implications on the efficacy of blood transfusion. J Blood Med 2018; 9: 111–115.
https://doi.org/10.2147/JBM.S163651
6. Chaurasiya AK, Patel AK, Prasad SB, Bhaskar RK, Jha U. Hematological Changes in Whole Blood Stored in Blood Bags Containing CPDA-1 Over a Period of 28 Days. Medphoenix 2023; 7(2): 42–46.
https://doi.org/10.3126/medphoenix.v7i2.50939
7. Sabir N, Ghafoor T, Fatima S, Lodhi R, Mehmood A, Zaman G. Prevalence and Association of Transfusion-Transmissible Infections with Age of Blood Donors: A Regional Transfusion Centre Study in Northern Pakistan. J Coll Physicians Surg Pak 2023; 33(09): 978–982.
https://doi.org/10.29271/jcpsp.2023.09.978
8. Zhong R, Han D, Wu X, Wang H, Li W, He Z, et al. An Evaluation of Morphological Changes and Deformability of Suspended Red Blood Cells Prepared Using Whole Blood with Different Hemoglobin Levels of Tibetans. Transfus Med Hemother 2021; 48(4): 210–219.
https://doi.org/10.1159/000513319
9. Antwi-Baffour S, Adjei JK, Tsyawo F, Kyeremeh R, Botchway FA, Seidu MA. A Study of the Change in Sodium and Potassium Ion Concentrations in Stored Donor Blood and Their Effect on Electrolyte Balance of Recipients. BioMed Res Int 2019; 2019(1): 8162975. https://doi.org/10.1155/2019/8162975
10. Marabi PM, Musyoki S, Amayo A. Biochemical changes in whole blood stored for transfusion at Bungoma County Referral Hospital, Kenya. Afr J Lab Med 2020; 9(1): 1–5.
https://doi.org/10.4102/ajlm.v9i1.1182.
11. Namjoshi A, Bhatia GM, Chaudhari AS, Trimbake S. Effect of blood storage on electrolyte levels. Int J Res Med Sci 2021; 9(2): 438–442. https://doi.org/10.18203/2320-6012.ijrms20210420
12. Tran LNT, González-Fernández C, Gómez-Pastora J. Impact of Different Red Blood Cell Storage Solutions and Conditions on Cell Function and Viability: A Systematic Review. Biomolecules 2024: 14(7): 813. https://doi.org/10.3390/biom14070813
13. Kandrashina S, Sherstyukova E, Shvedov M, Inozemtsev V, Timoshenko R, Erofeev A, et al. The Effect of the Acid-Base Imbalance on the Shape and Structure of Red Blood Cells. Cells 2024; 13(21): 1813. https://doi.org/10.3390/cells13211813
14. V. Bakaloudis AG. Andreadou M, Kalogiannidou IM, Osman NO, S. Mavromatidis K. Changes in Blood During Storage For Transfusion. PIJR 2022: 15; 118–121.
https://doi.org/10.36106/paripex
15. Sahoo J, Mahapatra S, Sahoo BB, Sahoo N. Changes in hematological and biochemical parameters and rate of hemolysis during the storage of packed RBC units: A prospective study. JLP 2025; 17: 88–94.
https://doi.org/10.25259/JLP_212_2024
16. Lee E, Musante K, Errico J, Rinder H, Kleinstein S, Tormey C, et al. Hematocrits of red blood cell units increase during storage due to changes in mean corpuscular volume, impacting outcomes of red cell exchange procedures. Am J Clin Pathol 2024; 162(Supplement_1): S157–S157.
https://doi.org/10.1093/ajcp/aqae129.348
17. Burke M, Sinha P, Luban NLC, Posnack NG. Transfusion-Associated Hyperkalemic Cardiac Arrest in Neonatal, Infant, and Pediatric Patients. Frontiers in Pediatrics. 2021; 9: 765306.
https://doi.org/10.3389/fped.2021.765306
18. Tkachenko A, Havranek O. Cell death signaling in human erythron: erythrocytes lose the complexity of cell death machinery upon maturation. Apoptosis 2025; 30(3-4): 652-673.
https://doi:10.1007/s10495-025-02081-5
Downloads
Published
License
Copyright (c) 2026 Rimsha Bashir, Saima Zahir, Yasmeen Batool, Safia Sartaj, Muzna Hussain

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.





