Canadian Blood Services research collaborate with BEST to understand how donor age impacts red blood cell quality

Tuesday, September 26, 2023 Dr. Travis Sztainert

In the realm of medical advancements, innovations which improve blood donation are not just interesting discoveries but can have an immense impact. Red blood cell (RBC) transfusions can be lifesaving for many recipients, yet, behind the scenes, a complex interplay of factors affects the quality of these RBCs stored under carefully controlled conditions. Recent research has shed light on an important aspect of this process: the impact of blood donor age. In this blog, we delve into a groundbreaking study and its editorial counterpart that offer fresh perspectives on how age might influence the quality of blood products. 

Optimizing storage conditions  

When whole blood is donated, it undergoes a series of carefully controlled processes to become a concentrated form of red blood cells (RBCs). Stored at cool temperatures and in an additive solution, these RBCs are now ready to be part of lifesaving treatment for many recipients. However, while RBCs are stored, a complex interplay of factors can affect the quality of RBCs. Recent research has shed light on one of these factors: donor age. In this blog, we delve into a new study and its editorial counterpart that offer fresh perspectives on how age might influence the quality of blood products.  

The process of RBC storage introduces changes referred to as the "storage lesion", which gradually affects the quality of the red cells. Specifically, storage lesion includes alterations in cell membrane flexibility, metabolism, decreased ATP levels, reduced oxygen-carrying capacity, increased hemolysis, oxidative stress, changes in cell size and shape, and potentially decreased lifespan after transfusion. While steps are being taken to optimize storage conditions, researchers have begun to explore blood donor-specific factors that influence this degradation. 

A recent study, was conducted by the Biomedical Excellence for Safer Transfusion (BEST) 

Collaborative, which includes Canadian Blood Services researchers: Senior Scientist Jason Acker, postdoctoral fellow Olga Mykhailova, and research associate Mackenzie Brandon-Coatham. This study uncovered a fascinating and unexpected relationship between donor age and red cell quality. The study examined RBCs from teenage donors (aged <= 18) and comparing them to samples from older donors (aged 75 and above). The findings revealed that red cells from teenage donors were more likely to undergo oxidative hemolysis. Oxidative hemolysis may be partially responsible for storage lesion as it involves the breakdown of RBCs by exposure to damaging particles like free radicals during storage. 

The study left researchers with a puzzle: what biological processes could explain this age-related variation in red cell quality? Some theories point to oxidative stress—the accumulation of damaging free radicals during refrigerated storage—as a potential culprit. Others delve into genetic factors, metabolic pathways, and antioxidant enzyme activities, all of which could contribute to donor-specific differences in red cell susceptibility to damage. 

Clinical implications  

The clinical implications of these findings remain a topic of debate. Some studies suggest potential links between donor age and clinical outcomes for RBC recipients, while others offer conflicting results. As researchers strive to uncover the mechanisms behind the age-quality relationship, they raise important questions: How can these insights inform donor eligibility criteria? Could they influence practices to optimize the quality of stored blood products? Further research is essential to ascertain the clinical relevance of these age-related differences. 

In the world of blood donation, every drop counts, and every aspect of the process holds the potential for discovery. The intersection of donor age and blood product quality opens a new avenue of exploration—one that could enhance our understanding of blood storage, inform donor eligibility guidelines, and ultimately impact patient care.  

Canadian Blood Services – Driving world-class innovation  

Through discovery, development and applied research, Canadian Blood Services drives world-class innovation in blood transfusion, cellular therapy and transplantation—bringing clarity and insight to an increasingly complex healthcare future. Our dedicated research team and extended network of partners engage in exploratory and applied research to create new knowledge, inform and enhance best practices, contribute to the development of new services and technologies, and build capacity through training and collaboration. Find out more about our research impact.  

The opinions reflected in this post are those of the author and do not necessarily reflect the opinions of Canadian Blood Services nor do they reflect the views of Health Canada or any other funding agency. 


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