This study was aimed to investigate the feasibility of cryopreserving red blood cells (RBCs) by loading with trehalose and to evaluate the effect of trehalose on lyophilized RBCs. Based on the thermal properties of RBC plasma membrane, the RBCs were incubated in 0.8 mol/L trehalose solution at 37 degrees C for 7 hours, and RBCs incubated in phosphate-buffered saline were used as control. The morphology of RBCs was observed by light and scanning electron microscopy, the hemolysis rate of loaded RBCs was detected by using cyanohemoglobin kit, the intracellular trehalose levels were assayed by sulfate anthrone method, the intracellular ATP and 2, 3-DPG levels were determined by bioluminescence assay and 2, 3-DPG kit respectively, meanwhile the deformation and osmotic fragility of RBCs were measured. The results showed that the intracellular trehalose concentration was 36.56 +/- 7.95 mmol/L, the electronical microscopic images of trehalose-loaded RBCs showed the membrane integrity, the hemolysis rate in trehalose-loaded RBCs was 15.663 +/- 3.848%, while hemolysis rate in controlled RBC was 5.03 +/- 1.85% (P < 0.05). Maximum index of deformation in trehalose-loaded RBC was 0.0289 +/- 0.00738, while maximum index of deformation in control group was 0.1200 +/- 0.0121 (P < 0.05), The level of ATP in trehalose-loaded RBC was 2.67 +/- 0.54 micromol/gHb, while the level of ATP in control group was 5.22 +/- 1.10 micromol/gHb (P > 0.05). Osmotic fragility data showed that trehalose exerted osmotic protection on RBC. During loading period the level of 2, 3-DPG in trehalose-loaded RBC was maintained close to the level in control. When trehalose-loaded RBCs were lyophilized and rehydrated, the recovery rate of hemoglobin was about 46.44 +/- 4.14% and that in control was 8.33 +/- 2.34% (P < 0.001). The recovery rate of hemoglobin of trehalose-loaded RBC was higher than that of control. It is concluded that trehalose can be integrated in the membrane of RBC in lyophilization state, maintain the integrity of RBC membrane, and significantly enhance the recovery rate of hemoglobin of cryopreserved RBCs. Cryopreserving RBCs by loading with trehalose is feasible.