Current Approaches to the Storage, Processing, and Quality Assessment of RBC and Platelet Components: A Narrative Review

This narrative review summarizes current findings regarding the storage, processing, and quality assessment of red blood cell, platelet components, and whole blood. Particular attention is given to technologies aimed at preserving cellular and functional properties during storage, such as cold storage, cryopreservation, hypoxic and anaerobic storage, modified gas environments, inert gases, leukoreduction, ionizing irradiation, and pathogen-reduction methods. The literature search was conducted in PubMed, Web of Science, Scopus and eLibrary.ru; it included experimental and clinical studies, reviews, guidelines, and regulatory or technical documents published from 1958 to 2026. Evidence demonstrates that various storage and processing strategies offer distinct advantages and limitations, influencing cellular metabolism, membrane and cytoskeleton organization, morphology, mechanical properties, and hemostatic function. While conventional quality-control parameters provide essential information, they may not adequately capture early structural, biomechanical, and molecular changes associated with storage lesions. Consequently, advanced analytical techniques, including atomic force microscopy, scanning ion-conductance microscopy, Raman spectroscopy, metabolomics, and proteomics, are receiving increased attention. These methods facilitate detailed analysis of cell morphology, membrane nanostructure, mechanical properties, hemoglobin status, metabolic changes, and molecular markers of storage-induced damage. Integrating conventional quality-control parameters with biophysical and molecular approaches may enable a more comprehensive evaluation of blood-component quality. Future research should prioritize standardization of emerging storage and analytical technologies, multicenter validation, and identification of parameters associated with post-transfusion recovery and functional efficacy.