title: Phosphatidylserine exposure on stored red blood cells as a parameter for donor-dependent variation in product quality.
abstract: BACKGROUND
  Exposure of phosphatidylserine on the outside of red blood cells contributes to recognition and removal of old and damaged cells. The fraction of phosphatidylserine-exposing red blood cells varies between donors, and increases in red blood cell concentrates during storage. The susceptibility of red blood cells to stress-induced phosphatidylserine exposure increases with storage. Phosphatidylserine exposure may, therefore, constitute a link between donor variation and the quality of red blood cell concentrates.
  
  
  METHODS
  In order to examine the relationship between storage parameters and donor characteristics, the percentage of phosphatidylserine-exposing red blood cells was measured in red blood cell concentrates during storage and in fresh red blood cells from blood bank donors. The percentage of phosphatidylserine-exposing red blood cells was compared with red blood cell susceptibility to osmotic stress-induced phosphatidylserine exposure in vitro, with the regular red blood cell concentrate quality parameters, and with the donor characteristics age, body mass index, haemoglobin level, gender and blood group.
  
  
  RESULTS
  Phosphatidylserine exposure varies between donors, both on red blood cells freshly isolated from the blood, and on red blood cells in red blood cell concentrates. Phosphatidylserine exposure increases with storage time, and is correlated with stress-induced phosphatidylserine exposure. Increased phosphatidylserine exposure during storage was found to be associated with haemolysis and vesicle concentration in red blood cell concentrates. The percentage of phosphatidylserine-exposing red blood cells showed a positive correlation with the plasma haemoglobin concentration of the donor.
  
  
  CONCLUSIONS
  The fraction of phosphatidylserine-exposing red blood cells is a parameter of red blood cell integrity in red blood cell concentrates and may be an indicator of red blood cell survival after transfusion. Measurement of phosphatidylserine exposure may be useful in the selection of donors and red blood cell concentrates for specific groups of patients.
authors.affiliation: Department of Laboratory Medicine - Laboratory of Medical Immunology, Radboud University Medical Centre, Nijmegen Institute for Infection Inflammation and Immunity, Nijmegen, The Netherlands.
authors.forename: Sip
authors.initials: S
authors.lastname: Dinkla
authors.affiliation: Department of Laboratory Medicine - Laboratory of Medical Immunology, Radboud University Medical Centre, Nijmegen Institute for Infection Inflammation and Immunity, Nijmegen, The Netherlands.
authors.forename: Malou
authors.initials: M
authors.lastname: Peppelman
authors.affiliation: Department of Laboratory Medicine - Laboratory of Medical Immunology, Radboud University Medical Centre, Nijmegen Institute for Infection Inflammation and Immunity, Nijmegen, The Netherlands.
authors.forename: Jori
authors.initials: J
authors.lastname: Van Der Raadt
authors.affiliation: Department of Donor Studies, Sanquin Research, Nijmegen, The Netherlands.
authors.forename: Femke
authors.initials: F
authors.lastname: Atsma
authors.affiliation: Department of Hematology, Radboud University Medical Centre, Nijmegen Institute for Infection Inflammation and Immunity, Nijmegen, The Netherlands.
authors.forename: Vera M J
authors.initials: VM
authors.lastname: Novotný
authors.affiliation: Unit Medical Affairs, Sanquin Blood Bank Southeast Region, Nijmegen, The Netherlands.
authors.forename: Marian G J
authors.initials: MG
authors.lastname: Van Kraaij
authors.affiliation: Department of Laboratory Medicine - Laboratory of Medical Immunology, Radboud University Medical Centre, Nijmegen Institute for Infection Inflammation and Immunity, Nijmegen, The Netherlands.
authors.forename: Irma
authors.initials: I
authors.lastname: Joosten
authors.affiliation: Department of Biochemistry, Radboud University Medical Centre, Nijmegen Centre for Molecular Life Sciences, Nijmegen, The Netherlands.
authors.forename: Giel J C G M
authors.initials: GJ
authors.lastname: Bosman
mesh_terms: D000328:Adult; D000367:Age Factors; D001789:Blood Group Antigens; D001793:Blood Preservation; D015992:Body Mass Index; D002470:Cell Survival / Q000187:drug effects; D004912:Erythrocytes / Q000166:cytology / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010718:Phosphatidylserines / Q000494:pharmacology*; D011786:Quality Control; D013997:Time Factors
chemical_list: D001789:Blood Group Antigens; D010718:Phosphatidylserines