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The first blood bank was established in Chicago in 1937, and, over the years, technological improvements have allowed blood to be transfused after being stored for as long as 42 days. However, blood is metabolically active and, during storage, potassium and hemoglobin leak from erythrocytes, and enzymes, such as 2,3-diphosphoglycerate (2,3-DPG), deteriorate. Because 2,3-DPG enhances release of oxygen to hypoxic tissues, transfusing blood near the end of its shelf life might be less effective than using blood collected more recently. However, within 24 to 48 hours of transfusion, the enzyme levels of circulating transfused red cells improve as 2,3-DPG depletion is reversed. Considerable controversy exists about whether differences between ol…