BACKGROUND: Stored red cells undergo progressive structural and functional changes over time. We tested the hypothesis that serious complications and mortality after cardiac surgery are increased when transfused red cells are stored for more than 2 weeks. METHODS: We examined data from patients given red-cell transfusions during coronary-artery bypass grafting, heart-valve surgery, or both between June 30, 1998, and January 30, 2006. A total of 2872 patients received 8802 units of blood that had been stored for 14 days or less ("newer blood"), and 3130 patients received 10,782 units of blood that had been stored for more than 14 days ("older blood"). Multivariable logistic regression with propensity-score methods was used to examine the effect of the duration of storage on outcomes. Survival was estimated by the Kaplan-Meier method and Blackstone's decomposition method. RESULTS: The median duration of storage was 11 days for newer blood and 20 days for older blood. Patients who were given older units had higher rates of in-hospital mortality (2.8% vs. 1.7%, P=0.004), intubation beyond 72 hours (9.7% vs. 5.6%, P<0.001), renal failure (2.7% vs. 1.6%, P=0.003), and sepsis or septicemia (4.0% vs. 2.8%, P=0.01). A composite of complications was more common in patients given older blood (25.9% vs. 22.4%, P=0.001). Similarly, older blood was associated with an increase in the risk-adjusted rate of the composite outcome (P=0.03). At 1 year, mortality was significantly less in patients given newer blood (7.4% vs. 11.0%, P<0.001). CONCLUSIONS: In patients undergoing cardiac surgery, transfusion of red cells that had been stored for more than 2 weeks was associated with a significantly increased risk of postoperative complications as well as reduced short-term and long-term survival. Copyright 2008 Massachusetts Medical Society.
BACKGROUND: Stored red cells undergo progressive structural and functional changes over time. We tested the hypothesis that serious complications and mortality after cardiac surgery are increased when transfused red cells are stored for more than 2 weeks. METHODS: We examined data from patients given red-cell transfusions during coronary-artery bypass grafting, heart-valve surgery, or both between June 30, 1998, and January 30, 2006. A total of 2872 patients received 8802 units of blood that had been stored for 14 days or less ("newer blood"), and 3130 patients received 10,782 units of blood that had been stored for more than 14 days ("older blood"). Multivariable logistic regression with propensity-score methods was used to examine the effect of the duration of storage on outcomes. Survival was estimated by the Kaplan-Meier method and Blackstone's decomposition method. RESULTS: The median duration of storage was 11 days for newer blood and 20 days for older blood. Patients who were given older units had higher rates of in-hospital mortality (2.8% vs. 1.7%, P=0.004), intubation beyond 72 hours (9.7% vs. 5.6%, P<0.001), renal failure (2.7% vs. 1.6%, P=0.003), and sepsis or septicemia (4.0% vs. 2.8%, P=0.01). A composite of complications was more common in patients given older blood (25.9% vs. 22.4%, P=0.001). Similarly, older blood was associated with an increase in the risk-adjusted rate of the composite outcome (P=0.03). At 1 year, mortality was significantly less in patients given newer blood (7.4% vs. 11.0%, P<0.001). CONCLUSIONS: In patients undergoing cardiac surgery, transfusion of red cells that had been stored for more than 2 weeks was associated with a significantly increased risk of postoperative complications as well as reduced short-term and long-term survival. Copyright 2008 Massachusetts Medical Society.
Authors: Alaina K Kipps; David Wypij; Ravi R Thiagarajan; Emile A Bacha; Jane W Newburger Journal: Pediatr Crit Care Med Date: 2011-01 Impact factor: 3.624
Authors: Christopher A Heid; Mitri K Khoury; Kayla Maaraoui; Charles Liu; Matthias Peltz; Michael A Wait; W Steves Ring; Lynn C Huffman Journal: J Surg Res Date: 2020-06-26 Impact factor: 2.192
Authors: Robert Neuman; Salim Hayek; Ayaz Rahman; Joseph C Poole; Vivek Menon; Salman Sher; James L Newman; Sulaiman Karatela; David Polhemus; David J Lefer; Christine De Staercke; Craig Hooper; Arshed A Quyyumi; John D Roback Journal: Transfusion Date: 2014-11-13 Impact factor: 3.157
Authors: Hong Man Yoon; Young-Woo Kim; Byung Ho Nam; Daniel Reim; Bang Wool Eom; Ji Yeon Park; Keun Won Ryu Journal: World J Gastroenterol Date: 2014-02-21 Impact factor: 5.742
Authors: Dong Wang; Irene Cortés-Puch; Junfeng Sun; Steven B Solomon; Tamir Kanias; Kenneth E Remy; Jing Feng; Meghna Alimchandani; Martha Quezado; Christine Helms; Andreas Perlegas; Mark T Gladwin; Daniel B Kim-Shapiro; Harvey G Klein; Charles Natanson Journal: Transfusion Date: 2014-03-03 Impact factor: 3.157