Packed red blood cells the red blood cells using special equipment, such as the IBM 2991 cell processor in a similar manner to washing RBCs. The processing (often termed "manufacture", since the end result is deemed a biologic biopharmaceutical product) and the storage can occur at a collection center and/or a blood bank. RBCs are mixed with an anticoagulant and storage solution which provides nutrients and aims to preserve viability and functionality of the cells (limiting their so-called "storage lesion"), which are stored at refrigerated temperatures for up to 42 days (in the US), except for the rather unusual long-term storage in which case
Red blood cell among the bilayer is the result of the function of several energy-dependent and energy-independent phospholipid transport proteins. Proteins called “Flippases” move phospholipids from the outer to the inner monolayer, while others called “floppases” do the opposite operation, against a concentration gradient in an energy dependent manner. Additionally, there are also “scramblase” proteins that move phospholipids in both directions at the same time, down their concentration gradients in an energy independent manner. There is still considerable debate ongoing regarding the identity of these membrane maintenance proteins in the red cell membrane. The maintenance of an asymmetric phospholipid distribution in the bilayer