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The Science

Hypoxic Storage

Hemanext is developing a technology to enable the storage of RBC under hypoxic conditions. Removing O2 during storage removes the primary “fuel” for oxidative stress1-11. Previous published research has demonstrated that preventing oxidative damage can alleviate many of the signs associated with storage lesion development, including:

Hypoxic storage has been shown to:

Improve maintenance of 2,3-DPG12,13

Reduce donor variability in RBC storage characteristics14

Improve deformability compared to conventionally stored RBC15

Decrease iron overload leading to higher proportion of viable RBC per unit transfused14

Hemanext continues to invest significant resources in developing the technology and demonstrating both its effect on the characteristics of RBCs during storage, and eventually in clinical usage with patients.

To learn more about the storage lesions and its clinical consequences, click here.


1. Hogman CF, de Verdier CH, Ericson A, Hedlund K, Sandhagen B. Effects of oxygen on red cells during liquid storage at +4 degrees C: I. Cell Shape and Total Adenylate Concentration as Determinant Factors for Posttransfusion Survival. Vox sanguinis 1986;51:27-34. 2. Wolfe LC. Oxidative injuries to the red cell membrane during conventional blood preservation. Seminars in hematology 1989;26:307-12. 3. Tsantes AE, Bonovas S, Travlou A, Sitaras NM. Redox imbalance, macrocytosis, and RBC homeostasis. Antioxidants & redox signaling 2006;8:1205-16. 4. Browne P, Shalev O, Hebbel RP. The molecular pathobiology of cell membrane iron: the sickle red cell as a model. Free radical biology & medicine 1998;24:1040-8. 5. Browne PV, Shalev O, Kuypers FA, et al. Removal of erythrocyte membrane iron in vivo ameliorates the athobiology of murine thalassemia. The Journal of clinical investigation 1997;100:1459-64. 6. Hebbel RP. Auto-oxidation and a membrane-associated ‘Fenton reagent’: a possible explanation for development of membrane lesions in sickle erythrocytes. Clinics in haematology 1985;14:129-40. 7. Hershko C. Mechanism of iron oxicity and its possible role in red cell membrane damage. Seminars in hematology 1989;26:277-85. 8. Jarolim P, Lahav M, Liu SC, Palek J. Effect of hemoglobin oxidation products on the stability of red cell membrane skeletons and the associations of skeletal proteins: correlation with a release of hemin. Blood 1990;76:2125-31. 9. Shalev O, Hebbel RP. Extremely high avidity association of Fe(III) with the sickle red cell membrane. Blood 1996;88:349-52. 10. Zinkham WH, Houtchens RA, Caughey WS. Carboxyhemoglobin levels in an unstable hemoglobin disorder (Hb Zurich): effect on phenotypic expression. Science 1980;209:406-8. 11. Wolfe LC, Byrne AM, Lux SE. Molecular defect in the membrane skeleton of blood bank-stored red cells. Abnormal spectrin-protein 4.1-actin complex formation. The Journal of clinical investigation 1986;78:1681-6. 12. Yoshida T, Prudent M, D’alessandro A. Red blood cell storage lesion: causes and potential clinical consequences. Blood Transfus 2019; 17 (1): 27-52. 13. Yoshida T, Shevkoplyas SS. Anaerobic storage of red blood cells. Blood Transfus 2010; 8 (4): 220-36 14. Yoshida T, Blair A, D’Alessandro A, et al. Enhancing uniformity and overall quality of red cell concentrate with anaerobic storage. Blood Transfus 2017; 15 (2): 172-181. 15. Burns JM, Yoshida T, Dumont LJ, et al. Deterioration of red blood cell mechanical properties is reduced in anaerobic storage. Blood Transfus 2016; 14 (1): 80-88.

Leader in the Science of Red Blood Cell Quality

Red Blood Cells Role in Healthcare

Today there are nearly 100 million units of blood prescribed.  The sole purpose of the majority of blood transfusions is to improve the oxygen carrying capacity of patients in need. This critical role has led to universal use of red blood cells as a foundation for modern healthcare systems. Standard refrigerated storage, however, leads to metabolic and physical changes of the red blood cells, referred to as the “storage lesion”.

Red Blood Cell Storage Lesion and Potential Clinical Consequences

With the recent publication entitled “Red Blood Cell Storage Lesion: Causes and Potential Clinical Consequences” in Blood transfusion, Tatsuro Yoshida, Michel Prudent, Angelo D’Alessandro have now provided a single comprehensive reference on this issue. This includes helping to understand the effects of oxidative damage, and the role it plays on red blood cell quality, specifically in assessing successful patient treatments and expected outcomes. The associated images help to demonstrate as well as guide us through the complexities of this issue.1

Hemanext Leads the Way

Hemanext is a leader in the science of red blood cell quality and its vision is to provide patients with the highest quality blood.  Read this article and see the figure below to learn more about oxidative damage to red blood cells.

Consequences Caused by Oxidative Damage and Metabolic impairment to Red Blood Cells*