Metabolomics of AS-5 RBC supernatants following routine storage

Background and Objectives The safety and efficacy of stored red blood cells (RBCs) transfusion has been long debated due to retrospective clinical evidence and laboratory results, indicating a potential correlation between increased morbidity and mortality following transfusion of RBC units stored longer than 14 days. We hypothesize that storage in Optisol additive solution‐5 leads to a unique metabolomics profile in the supernatant of stored RBCs. Materials and Methods Whole blood was drawn from five healthy donors, RBC units were manufactured, and prestorage leucoreduced by filtration. Samples were taken on days 1 and 42, the cells removed, and mass spectrometry‐based metabolomics was performed. Results The results confirmed the progressive impairment of RBC energy metabolism by day 42 with indirect markers of a parallel alteration of glutathione and NADPH homeostasis. Moreover, oxidized pro‐inflammatory lipids accumulated by the end of storage. Conclusion The supernatants from stored RBCs may represent a burden to the transfused recipients from a metabolomics standpoint.