Mischa L Covington, Patricia E Zerra, Samata P Varadkar, Dominique Paz, Rebecca C Hale, Connie M Arthur, John D Roback, Ross M Fasano, Marianne E M Yee, Sean R Stowell
Patients with sickle cell disease (SCD) can present with numerous complications, primarily associated with red blood cell (RBC) turnover, hemolysis, and associated immune pathway activation. While RBC transfusions can alleviate some of the most severe complications, the survival of transfused RBCs in chronically transfused patients varies significantly. To address this, novel protocols combining RBC biotinylation with flow cytometric detection have been developed, enabling more precise measurements of post-transfusion RBC survival. In an effort to elucidate the half-life of transfused RBCs in chronically transfused patients, cell-surface biotinylation has been integrated with Annexin V staining as a proof of concept. This approach allows for the examination of both RBC survival and changes in RBC lipid distribution, which often accompany cellular removal, providing valuable insights into the complex dynamics of RBC transfusions in patients with SCD.