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Table 1 Characteristics of the storage lesion.

From: Blood transfusion in the critically ill: does storage age matter?

Storage Effect Consequences
Changes to red cell structure and function  
   Cellular membrane changes Erythrocytes change shape
Decreased survivability
   Decreased 2,3-diphsophoglycerate Increased oxygen affinity
Decreased oxygen delivery
   Decreased adenosine triphosphate Erythrocytes change shape
Increased cell fragility
Less resistance to oxidative stress
Changes in red cell storage medium  
Accumulation of bioactive substances
(cytokines, histamines, lipids, enzymes)
Increased oxidative environment
Febrile transfusion reactions
Immunologic activation/suppression