Red blood cell form. When red blood cells sometimes occur as a stack, flat side next to flat side. This is known as "rouleaux formation", and it occurs more often if the levels of certain serum proteins are elevated, as for instance during inflammation. Red blood cells can be obtained from whole blood by centrifugation, which separates the cells from the blood plasma in a process known as blood fractionation. Packed red blood cells, which are made in this way from whole blood with the plasma removed, are used in transfusion medicine. During plasma donation, the red blood cells are pumped back into
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