Red blood cell metabolism and preservation

Human red blood cells (RBCs), mature and released from the bone marrow, lack nuclei, ribosomes, and mitochondria. This chapter discusses red blood cell metabolism, taking into account intermolecular interactions of importance for the primary function of hemoglobin, which is oxygen and carbon dioxide transport. Under physiologic circumstances, the energy that the red cell requires is derived through the breakdown of glucose to lactate or pyruvate. The red cell membrane is composed of a phospholipid bilayer containing cholesterol molecules and membrane protein. Presumably eryptosis marks RBCs at the end of their normal lifespan for removal from the vascular system by splenic or other macrophages. Red cell loss of viability during storage is different than red cell senescence in the body. RBC storage systems have historically been validated by demonstrating that the stored cells do not hemolyze during storage and that they circulate normally after reinfusion.