Due to the unique properties of chitosan (antibacterial and stimulating tissue repair factors) in improving cell function, modified chitosan derivatives are widely used to improve the function of blood products. However, interaction of chitosan positive surface charge with negatively charged blood cells and anionic proteins, increases hemolysis, platelet activation, and dysfunction of plasma proteins, so the use of chitosan in blood applications requires surface modifications. Therefore, in this review study, we review the literature (2010- 2022) to determine whether the charged-modified chitosan could eliminate the effects of chitosan on blood products and prepare a platform for more research to improve the preservation of the blood products such as erythrocytes, platelets and plasma proteins (albumin, immunoglobulin (Ig) and factor (FVIII)). Overall, the results of this review study show that negative surface-charged chitosan can increase hematopoiesis and increase the preservation of erythrocytes, platelet, and plasma products. Modified chitosan can be used as an anticoagulant compound for purification and filtration of plasma proteins, gene transfer of FVIII, and to increase the stability of plasma proteins. In addition, due to its antibacterial and hemostatic properties, negatively charged chitosan can stimulate coagulation factors and rapid wound healing and can be used in the production of wound dressings. This review study provides researchers with a new insight into the effectiveness of negative-charged chitosan in improving the preservation of blood products including erythrocytes, platelets, and plasma products (albumin, immunoglobulin, and FVIII) and promises to increase the efficacy of negative-charged chitosan in the future research.
