Engineered Supercooling Systems for Enhanced Long-Term Preservation of Large-Volume Red Blood Cells in Commercial Blood Bags

Extending the shelf life of red blood cells (RBCs) is vital for transfusion medicine, yet traditional storage methods like refrigeration and cryopreservation suffer from limitations such as storage lesions and ice-induced damage. We developed an improved supercooling preservation system for large-volume (100 ml) RBC suspensions in commercial polyvinylchloride (PVC) blood bags by minimizing favorable sites of ice nucleation and maintaining precise thermal control at − 8°C. This engineered protocol significantly reduces hemolysis, metabolic degradation, and oxidative stress while preserving RBC membrane integrity and functionality for up to 63 days. In vivo transfusion studies in New Zealand white rabbits demonstrate that supercooling-preserved RBCs achieve higher post-transfusion recovery rates, outperforming conventional storage methods. Our scalable and cost-effective supercooling system integrates seamlessly with existing blood banking infrastructure, addressing critical needs for extended RBC storage and improved transfusion outcomes. This advancement enhances blood supply reliability and patient care, representing a significant breakthrough in transfusion medicine.