Wouldn’t the cold temperatures kill the blood cells?
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At the very basic level it’s the same as putting food in the fridge, it will spoil over time but cooling things down slows the decay process. Of course there’s a big difference between cooling and freezing blood which would destroy the cells
It’s only usable for about 42 days* after it’s been removed which is around half the life of a red cell in the human body
The cold actually helps to preserve it just like anything else in a fridge, by slowing the breakdown process of the cells. In fact, we have to throw it out if it’s been at room temperature for too long.
In order to prepare whole blood for transfusion it is separated. The red cells are separated from the plasma and have their white cells and platelets removed*. The final product is called packed red cells because it’s just red cells*.
Additionally, SAGM is added to prevent clots and last longer*
And some products receive more processing depending on the needs of the patient.
Source: medical laboratory technologist. With training in transfusion services.
* Simplifications made for eli5 transfusion is a highly regulated field with various site-specific requirements
Mammalian red blood cells are not very “alive” to begin with. They don’t have a nucleus, DNA, ribosomes, or mitochondria; they’re basically a wad of hemoglobin in a cell membrane. So there aren’t a lot of living processes to be interrupted by cold.
As others have said, fridge is fine. Putting it in the microwave on the other hand, not so good:
https://www.mcgill.ca/oss/article/controversial-science-health-household-products-quackery/microwaves-and-blood
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