Erythrocyte membrane resistance of actively smoking donors in leukoreduced packed red blood cells during storage: Focus on oxidative stress

Background — Leukoreduced (with removed white blood cells) packed red blood cells (PRC) are commonly for blood transfusions to reduce post-transfusion effects. The number of active smokers in Indonesia is relatively high; consequently, many of them could be blood donors since no regulations are set to rule them out. However, leukoreduced PRC in active smokers are highly risky as they may undergo erythrocyte membrane damage caused by oxidative stress, which hinders fighting the free radicals generated by smoking. Objective — Our study examined the impact of oxidative stress on membrane resistance of leukoreduced PRC, produced from actively smoking donors, during its storage. Material and Methods − The study was descriptive and cross-sectional in its design. It examined 12 nonsmoking (NS), 12 lightly smoking (LS), and 12 moderately smoking (MS) donors. Leukoreduced PRC produced from donors was separated into three groups: NS, LS, and MS. We performed assessments of malondialdehyde (MDA), superoxide dismutase enzyme (SOD) activity, and osmotic fragility test (OFT) on days 0 through day 35 of storage (D0-D35). We used nonparametric statistical tests (Kruskal-Wallis and Mann-Whitney). We assumed that p<0.05 implied statistically significant difference. Results — The Kruskal-Wallis test demonstrated differences on D0, D7, D14, D21, D28, and D35 between all three groups in MDA, SOD, and OFT, with p < 0.05. This study showed that leukoreduced PRC storage increased oxidative stress. The highest oxidative stress occurred in the MS group. Conclusion — Erythrocyte membrane fragility and resistance correlated with oxidative stress. Blood components of leukoreduced PRC produced from moderate smokers should be banned for repeated transfusions.