Sickle Cell Trait Increases Red Blood Cell Storage Hemolysis and Post-Transfusion Clearance in Mice
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Sickle cell trait (HbAS) RBC exhibit increased resistance to osmotic shock compared to normal (HbAA) RBCs.

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HbAS RBC show accelerated storage-related aging and post-transfusion clearance after cold storage compared to HbAA RBC.

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Reduced post-transfusion survival of stored HbAS RBCs is not due to intravascular hemolysis but due to tissue sequestration.

In allogeneic transfusions, red blood cells (RBCs) are collected and stored for up to 42 days. Historically, donor RBC genetic background is only considered in the context of major Rh and ABO blood groups. This study shows that donor-specific genetic factors such as sickle cell trait, the benign heterozygote state of sickle cell disease, accelerate storage-related hemolysis and reduces RBC post-transfusion survival in mice. Impaired post-transfusion recovery is due to enhanced sequestration in organ microcirculation. Further studies are warranted to determine an appropriate earlier outdate for HbAS RBC units, particularly in malaria-endemic regions where sickle cell trait prevalence is high.

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