Haematological Changes, Lactate Dehydrogenase, and Red Blood Cell Antioxidant Enzyme Activity During Storage of Blood

Abstract

Background: Red blood cell (RBC) transfusion is widely used to correct anemia and restore oxygen transport. During storage at 4 ± 2°C, however, RBCs undergo progressive structural and biochemical alterations, which may affect their clinical effectiveness and safety.

Objective: This study aimed to investigate hematological changes and antioxidant enzyme activities—superoxide dismutase (SOD), glutathione peroxidase (GPX), and lactate dehydrogenase (LDH) in stored RBCs at different time points.

Methods: An exploratory study was conducted in the Departments of Hematology and Biochemistry, University of Health Sciences, Lahore, Pakistan. Whole blood (500 mL) from 25 healthy donors was collected into quadruple bags. About 90 mL from each mother bag was aseptically distributed into three satellite bags and stored at 4 ± 2°C. Samples were analyzed at baseline (day 0) and on days 14, 28, and 35. Hematological indices were measured using a fully automated hematology analyzer, while SOD, GPX, and LDH were assessed with a semi-automated chemistry analyzer. Data were analyzed using SPSS version 25.

Results: A significant reduction in SOD and GPX activity, accompanied by a rise in LDH levels, was detected by day 14 compared with baseline (p ? 0.05). White blood cell (WBC) counts showed a steady decline during storage. In contrast, mean corpuscular volume (MCV) and red cell distribution width (RDW) significantly increased with longer storage duration (p ? 0.05).

Conclusion: RBCs maintained better hematological stability and antioxidant enzyme activity within the first 14 days of storage. Shorter storage intervals may therefore be preferable, particularly for transfusion-dependent patients requiring repeated support.