Red blood cell evolved a mode of red blood cell development substantially different from the mammalian norm. Overall, mammalian red blood cells are remarkably flexible and deformable so as to squeeze through tiny capillaries, as well as to maximize their apposing surface by assuming a cigar shape, where they efficiently release their oxygen load. Red blood cells in mammals are unique amongst vertebrates as they do not have nuclei when mature. Red blood cells of mammals cells have nuclei during early phases of erythropoiesis, but extrude them during development as they mature; this provides more space for hemoglobin. The red blood cells without
Packed red blood cells are kept with a minimal amount of fluid. Generally, an additive solution of citrate, dextrose, and adenine is mixed with the cells to keep them alive during storage. This process is sometimes done as automated apheresis, where the centrifuging and mixing take place at the donation site. Red blood cells are sometimes modified to address specific patient needs. The most common modification is leukoreduction, where the donor blood is filtered to remove white cells, although this is becoming increasingly universal throughout the blood supply (over 80% in the US, 100% in Europe). The blood may also be irradiated, which destroys