คุณภาพ การเปลี่ยนแปลงระหว่างการเก็บรักษา และผลกระทบทางคลินิกของ ส่วนประกอบโลหิต : นัยสำคัญต่อเวชปฏิบัติการให้เลือด

Napaporn  Mosikanon; Wasita  Navajitpaiboon

Authors

Napaporn Mosikanon Regional Blood Centre XI, Nakhon Si Thammarat, Thai Red Cross Society.
Wasita Navajitpaiboon Regional Blood Centre XI, Nakhon Si Thammarat, Thai Red Cross Society.

Keywords:

blood components, red blood cells, platelets, plasma, transfusion medicine, oxidative stress, precision transfusion medicine

Abstract

Blood transfusion and blood component therapy are essential in modern clinical practice. However, blood components undergo biochemical, structural, and functional deterioration during storage, known as “storage lesions,” which may affect transfusion efficacy and safety. This review summarizes current knowledge regarding blood component quality, the mechanisms of storage lesions in red blood cells, platelets, and plasma, their clinical implications, and strategies to minimize these effects.

In red blood cells, storage lesions are associated with reduced adenosine triphosphate (ATP) and 2,3-bisphosphoglycerate levels, oxidative stress, and membrane alterations. Platelets exhibit morphological changes and increased activation marker expression, while plasma demonstrates decreased levels of certain coagulation factors during storage.

Although experimental evidence suggests that storage lesions may impair blood component function, clinical outcomes remain inconsistent. Most studies report limited impact in general patient populations, but vulnerable groups, such as critically ill patients, neonates, and those requiring massive transfusion, may be more affected.

Current approaches to improve blood component quality include additive solutions, leukoreduction, platelet additive solutions, and omics-based technologies for advanced quality assessment. Future directions are moving toward precision transfusion medicine, which focuses on tailoring blood component selection to individual patient characteristics. Understanding storage lesions and their clinical significance is crucial for improving transfusion safety, efficacy, and the future development of transfusion medicine.

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