Does Transfusion With "Old" Blood Place the Surgical Patient at Risk?
Does Transfusion With "Old" Blood Place the Surgical Patient at Risk?
Koch CG, Li L, Sessler DI, et al
N Engl J Med. 2008;358:1229-1239
Does the duration of storage of transfused blood have any impact on morbidity and mortality? To determine this, the authors compared the results after transfusion with "new" or "old" blood given to patients undergoing open heart surgery. New blood was defined as having been stored for 14 or fewer days; old blood was stored for longer periods. Hospital mortality for patients given old blood was 2.8% compared to 1.7% for patients who received new blood (P = .004). In addition, old blood was associated with significantly increased hospital morbidity. At 1 year, overall mortality was 11% in patients given old blood compared to 7.4% for those given new blood.
If the findings can be generalized to patients undergoing noncardiac operations, this report could have wide-reaching implications for all surgical patients requiring transfusion. Currently, the US Food and Drug Administration allows blood to be used with storage periods up to 42 days. Is this too long? Does older blood carry a higher risk of immediate- and long-term adverse events? If so, shortening the recommended storage period will disrupt our blood banking system and will require either a reduction in the amount of blood transfused (currently about 14 million units per year), or a greatly increased supply of donor blood.
Abstract
Koch CG, Li L, Sessler DI, et al
N Engl J Med. 2008;358:1229-1239
Does the duration of storage of transfused blood have any impact on morbidity and mortality? To determine this, the authors compared the results after transfusion with "new" or "old" blood given to patients undergoing open heart surgery. New blood was defined as having been stored for 14 or fewer days; old blood was stored for longer periods. Hospital mortality for patients given old blood was 2.8% compared to 1.7% for patients who received new blood (P = .004). In addition, old blood was associated with significantly increased hospital morbidity. At 1 year, overall mortality was 11% in patients given old blood compared to 7.4% for those given new blood.
If the findings can be generalized to patients undergoing noncardiac operations, this report could have wide-reaching implications for all surgical patients requiring transfusion. Currently, the US Food and Drug Administration allows blood to be used with storage periods up to 42 days. Is this too long? Does older blood carry a higher risk of immediate- and long-term adverse events? If so, shortening the recommended storage period will disrupt our blood banking system and will require either a reduction in the amount of blood transfused (currently about 14 million units per year), or a greatly increased supply of donor blood.
Abstract