Which biochemical change occurs in packed red cells during prolonged storage and contributes to impaired tissue oxygen delivery immediately after transfusion?
- A Fall in 2,3-DPG causing a leftward shift of the oxygen dissociation curve ✓
- B Rise in 2,3-DPG causing a rightward shift of the oxygen dissociation curve
- C Fall in potassium concentration due to active pumping by stored cells
- D Progressive rise in intracellular ATP levels
Correct answer: A. Fall in 2,3-DPG causing a leftward shift of the oxygen dissociation curve
Explanation
During storage, red cell 2,3-DPG depletes within 1 to 2 weeks, shifting the oxygen dissociation curve to the left so haemoglobin releases oxygen less readily at tissue PO2. Levels recover within 12 to 24 hours after transfusion. Potassium actually rises in stored plasma due to cell membrane leakage, not falls, and ATP declines progressively rather than rising. These changes together constitute the red cell storage lesion.
Reference: Morgan and Mikhail's Clinical Anesthesiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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