BACKGROUND: Blood for transfusion is stored for up to 42 days. Older blood develops lesions and accumulates potentially injurious substances. Some studies report increasing toxicity as blood ages. We assessed the safety of transfused older versus newer stored blood. STUDY DESIGN AND METHODS: PubMed, Scopus, and Embase were searched using terms new and old and red blood cell and storage through May 6, 2011, for observational and randomized controlled studies comparing outcomes using transfused blood having longer and shorter storage times. Death was the outcome of interest. RESULTS: Twenty-one studies were identified, predominantly in cardiac surgery (n=6) and trauma (n=6) patients, including 409,966 patients. A test for heterogeneity of these studies' results was not significant for mortality (I(2)=3.7%, p=0.41). Older blood was associated with a significantly increased risk of death (odds ratio, 1.16; 95% confidence interval [CI], 1.07-1.24). Using available mortality data, 97 (95% CI, 63-199) patients need to be treated with only new blood to save one life. Subgroup analysis of these trials indicated that the increased risk was not restricted to a particular type of patient, size of trial, or amount of blood transfused. CONCLUSION: Based on available data, use of older stored blood is associated with a significantly increased risk of death.
BACKGROUND: Blood for transfusion is stored for up to 42 days. Older blood develops lesions and accumulates potentially injurious substances. Some studies report increasing toxicity as blood ages. We assessed the safety of transfused older versus newer stored blood. STUDY DESIGN AND METHODS: PubMed, Scopus, and Embase were searched using terms new and old and red blood cell and storage through May 6, 2011, for observational and randomized controlled studies comparing outcomes using transfused blood having longer and shorter storage times. Death was the outcome of interest. RESULTS: Twenty-one studies were identified, predominantly in cardiac surgery (n=6) and trauma (n=6) patients, including 409,966 patients. A test for heterogeneity of these studies' results was not significant for mortality (I(2)=3.7%, p=0.41). Older blood was associated with a significantly increased risk of death (odds ratio, 1.16; 95% confidence interval [CI], 1.07-1.24). Using available mortality data, 97 (95% CI, 63-199) patients need to be treated with only new blood to save one life. Subgroup analysis of these trials indicated that the increased risk was not restricted to a particular type of patient, size of trial, or amount of blood transfused. CONCLUSION: Based on available data, use of older stored blood is associated with a significantly increased risk of death.
Authors: Albert H M van Straten; Mohamed A Soliman Hamad; André A J van Zundert; Elisabeth J Martens; Joost F ter Woorst; Andre M de Wolf; Volkher Scharnhorst Journal: J Thorac Cardiovasc Surg Date: 2011-01 Impact factor: 5.209
Authors: Simon D Robinson; Christian Janssen; Eric B Fretz; Brian Berry; Alex J Chase; Anthony Della Siega; Ronald G Carere; Anthony Fung; Gerald Simkus; W Peter Klinke; J David Hilton Journal: Am Heart J Date: 2010-05 Impact factor: 4.749
Authors: Jordan A Weinberg; Gerald McGwin; Russell L Griffin; Vu Q Huynh; Samuel A Cherry; Marisa B Marques; Donald A Reiff; Jeffrey D Kerby; Loring W Rue Journal: J Trauma Date: 2008-08
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: 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
Authors: Steven B Solomon; Dong Wang; Junfeng Sun; Tamir Kanias; Jing Feng; Christine C Helms; Michael A Solomon; Meghna Alimchandani; Martha Quezado; Mark T Gladwin; Daniel B Kim-Shapiro; Harvey G Klein; Charles Natanson Journal: Blood Date: 2012-12-18 Impact factor: 22.113