Storage Related Hematological and Biochemical Changes in Sickle Cell Trait Donor Blood at Kisumu Regional Blood Transfusion Centre, Kenya

Abstract

Sickle cell trait (HbAS) donor blood is widely used for transfusion in malaria-endemic regions, yet evidence comparing its storage-related deterioration with normal hemoglobin (HbAA) blood remains limited. This study evaluated hematological and biochemical changes occurring during storage of HbAS and HbAA donor blood at the Kisumu Regional Blood Transfusion Centre, Kenya. A prospective laboratory-based experimental design was conducted using 60 donor blood units comprising 30 HbAS and 30 HbAA units selected from 336 voluntary blood donors screened for sickle cell trait. Hematological and biochemical parameters were measured at baseline and weekly for 28 days using standardized laboratory methods, while data were analyzed using one-way ANOVA, R statistical software, and SPSS version 27 at a significance level of p<0.05. Both donor groups demonstrated progressive storage lesions, although changes were consistently more pronounced in HbAS blood. Hemoglobin and hematocrit increased, whereas platelet and total white blood cell counts declined markedly. Percentage hemolysis reached 0.78% in HbAS compared with 0.54% in HbAA by day 28. Lactate dehydrogenase increased steadily from 210.87 to 635.80 U/L in HbAS and from 196.09 to 530.69 U/L in HbAA, indicating greater cellular degradation in HbAS blood. Plasma potassium increased substantially from 4.98 to 19.28 mmol/L in HbAS versus 4.53 to 14.92 mmol/L in HbAA, while sodium declined progressively in both groups. Plasma bilirubin also increased throughout storage, reaching 19.98 ng/dL in HbAS and 13.48 ng/dL in HbAA, reflecting enhanced erythrocyte breakdown. The findings demonstrate that HbAS donor blood undergoes greater storage-related hematological and biochemical deterioration than HbAA blood, potentially compromising transfusion quality and safety. Routine screening for sickle cell trait among blood donors, differential storage protocols with shorter storage durations for HbAS units, and regular monitoring of biomarkers including lactate dehydrogenase, potassium, bilirubin, and hemolysis are recommended to improve transfusion safety and optimize blood quality in endemic settings.