Transfusions of whole blood, plasma, red blood cell (RBC) concentrates, and platelet concentrates (PCs) are critical for treating a wide range of health conditions, including anemia, cancer, complications during pregnancy and childbirth, severe trauma, and surgical procedures. Additionally, transfusions are often required for patients with sickle cell disease or thalassemia. According to the World Health Organization (WHO), approximately 120 million units of blood are donated annually [1]. However, the demand for transfusions can exceed the available supply, as blood cannot be stored for extended periods. Blood products are considered valuable resources at multiple levels. The processes involved in generating blood products are highly regulated and classified. For instance, PCs can be derived either through apheresis from a single donor (SDA) or from a combination of platelet (buffy coat) samples from 5 to 8 different blood donors [2]. The processes of collection, storage, and transfusion are rigorously regulated to ensure the high quality of blood components and minimize the risk of transfusion-related adverse reactions (ARs). Unfortunately, after transfusion, ARs can be observed. RBC and PC transfusions are linked to the highest rates of ARs. In fact, according to WHO, worldwide data recorded 12.2 out of 100 000 units of blood components causing ARs [1]. In the USA, 18.5 units out of 100 000 caused serious ARs, compared with Canada with 1560 reactions caused by transfusion, 4.8% were considered life-threatening 1, 3. In Europe, the incidence of severe reactions per 100 000 transfusions was 9.7 [1] within France, of 524 196 patients who received transfusions, 5412 suffered ARs, 92% of which were nonsevere [4]. The storage of the blood component could be a risk of AR with the release of lipid mediators or proteins etc. 5, 6, 7••, 8, 9•, 10. However, the storage involved several morphological modifications that can lead to impaired aggregation, activation, and cell interaction 11, 12. During storage, platelet morphology changes from discoid to cells with pseudopodia, and for high time of storage platelet could be lysed [12]. Changes in molecules on the surface were also observed through the storage time, with a reduction of G-protein–coupled protease-activated receptors (PAR4), exposure and shedding of CD42b (GPI bα) and GPVI. In parallel, platelets α-granules release CD62P and soluble CD40 ligand (sCD40L) and RANTES to the extracellular space [12]. The shedding of CD42b is associated with the decreased capability of platelet adhesion at high shear or premature platelet clearance. GPVI (most important collagen receptor) release leads to a lower answer to aggregation as well as adhesion on collagen [12].

This review will highlight recent findings on the composition of platelet and RBC, with a specific focus on lipids and proteins, and explore their potential role in transfusion-related ARs.