Relationship between the Third Component of Human Complement (C3) Bound to Stored Preserved Erythrocytes and Their Viability in vivo1

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Abstract
In this study we evaluated whether the 4 °C storage‐induced coating of red blood cells (RBC) with molecules of the third component of human complement, C3, affects the viability of the preserved RBC. To this end, we determined whether the amount of C3 bound to preserved RBC correlated with the 24‐hour survival value. The % anti‐C3c‐induced agglutination of stored RBC provided an estimate of the amount of RBC‐bound C3. In some cases, the number of RBC‐bound C3c‐containing molecules was also quantitated. The 24‐hour survival of autologous RBC was measured in 114 cases. All units were initially stored at 4°C as RBC concentrates followed in 21 cases by frozen storage and in 75 cases by biochemical rejuvenation and frozen storage.The data showed a significant correlation between % anti‐C3c‐induced agglutination of the preserved RBC and the length of 4°C storage of the RBC concentrates. Neither freezing nor rejuvenation cleaved the C3c fragment from stored RBC. The 24‐hour survival was significantly and negatively correlated with both the storage length of RBC concentrates at 4°C and with the amount of RBC‐bound C3 but not with RBC ATP level. These data suggest that the RBC‐bound C3 either contributes to or is a marker for the extent of the preservation injury of RBC.