Refrigerated storage of red blood cell (RBC) units under standard blood bank conditions produces the red cell storage lesion in vitro, which results in the rapid in-vivo clearance of transfused storage-damaged red cells. Multiple observational studies suggest that transfusions of RBC units stored for longer than 14-21 days produce adverse clinical consequences in human patients. Although the validity of these clinical associations remains controversial, little is known about the mechanisms underlying the clearance of refrigerator storage-damaged red cells and the subsequent downstream effects. Based on studies of in-vitro cell culture and in-vivo trials in mice, dogs, and humans, the iron hypothesis was developed to explain, at least, some of the implicated adverse effects related to infection, inflammation, and immunity. This lecture will describe these ideas and illustrate them using experimental data.

Award Description: This award began as a lectureship in 1963 and was designated as a Memorial Award in 1983. The Emily Cooley Memorial Award and Lectureship recognizes an individual who has demonstrated teaching ability and has made a major contribution to the field of transfusion medicine or cellular therapies.