Age of Red Cells for Transfusion and Outcomes in Critically Ill Adults

Cooper, Jamie; McQuilten, Zoe; Nichol, Alistair; Ady, Bridget; Aubron, Cécile; Bailey, Michael; Bellomo, Rinaldo; Gantner, Dashiell; Irving, David O.; Kaukonen, Kirsi‐Maija; McArthur, Colin; Murray, Lynne; Pettilä, Ville; French, Craig

doi:10.1056/nejmoa1707572

Cited by 150 publications

(170 citation statements)

References 16 publications

Supporting

Mentioning

160

Contrasting

Unclassified

Order By: Relevance

“…Although there are evidences reporting the potential harm of transfusing stored RBCs [1,2,3,4,5,6,7,8,9,10,11], other studies on randomized clinical trials reported no difference in mortality of patients who received fresher versus older RBCs [23,24,25,26]. Most published clinical studies are non-randomized observational studies with methodologic limitations.…”

Section: Discussionmentioning

confidence: 99%

MicroRNA Dysregulation Associated with Red Blood Cell Storage

Chen

Xie

Xing

et al. 2018

Transfus Med Hemother

View full text Add to dashboard Cite

Introduction: Stored red blood cells (RBCs) undergo storage lesions involving morphological, physiological and biochemical changes. MicroRNAs (miRNAs) have important functions in cell apoptosis and life processes. Therefore, the aim of this study was to explore potential roles of miRNAs in the damage of stored RBCs. Methods: Blood samples were collected from 13 healthy male O-type donors, and leuko-reduced RBCs were divided into fresh RBC group and 20-day storage RBC group. Results: Eight predicted miRNAs with modified expressions with an intersection ≥ 3 were found dysregulated in the 20-day storage RBC group and involved in apoptosis and senescence signaling pathway: miR-31-5p, miR-196a-5p, miR-203a, miR-654-3p and miR-769-3p were increased, while miR-96-5P, miR-150-5P and miR-197-3p were decreased. Evidence associating miR-31-5p, miR-203a, miR-654 and miR-769 to RBCs or blood in general are not available. Conclusions: Dysregulated miRNAs might represent potential biomarkers to identify storage lesions, and their detection might help to evaluate the quality of stored RBCs.

show abstract

Section: Discussionmentioning

confidence: 99%

MicroRNA Dysregulation Associated with Red Blood Cell Storage

Chen

Xie

Xing

et al. 2018

Transfus Med Hemother

View full text Add to dashboard Cite

show abstract

“…19 While large RCTs have not associated PRBC age with mortality, these RCTs did not test PRBCs at the end of shelf life. 7–9,21 …”

Section: Discussionmentioning

confidence: 99%

Transfusion of packed red blood cells at the end of shelf life is associated with increased risk of mortality – a pooled patient data analysis of 16 observational trials

David

Middelburg

et al. 2018

Haematologica

View full text Add to dashboard Cite

Observational studies address packed red blood cell effects at the end of shelf life and have larger sample sizes compared to randomized control trials. Meta-analyses combining data from observational studies have been complicated by differences in aggregate transfused packed red blood cell age and outcome reporting. This study abrogated these issues by taking a pooled patient data approach. Observational studies reporting packed red blood cell age and clinical outcomes were identified and patient-level data sets were sought from investigators. Odds ratios and 95% confidence intervals for binary outcomes were calculated for each study, with mean packed red blood cell age or maximum packed red blood cell age acting as independent variables. The relationship between mean packed red blood cell age and hospital length of stay for each paper was analyzed using zero-inflated Poisson regression. Random effects models combined paper-level effect estimates. Extremes analyses were completed by comparing patients transfused with mean packed red blood cell aged less than ten days to those transfused with mean packed red blood cell aged at least 30 days. sixteen datasets were available for pooled patient data analysis. Mean packed red blood cell age of at least 30 days was associated with an increased risk of in-hospital mortality compared to mean packed red blood cell of less than ten days (odds ratio: 3.25, 95% confidence interval: 1.27–8.29). Packed red blood cell age was not correlated to increased risks of nosocomial infection or prolonged length of hospital stay.

show abstract

“…RECESS4 enrolled adults having scheduled complex cardiac surgery. TRANSFUSE6 and ABLE3 enrolled adults admitted to critical care units. INFORM5 enrolled a broad patient population, but many participants were at low risk of death (the trial’s primary outcome), which may be a limitation when evaluating the clinical consequences of storage duration.…”

Section: Importance Of Case MIXmentioning

confidence: 99%

“…Establishing clinical consequences of storage effects on red blood cells would be of major importance for blood transfusion services. The four most recent randomised trials (ABLE,3 RECESS,4 INFORM,5 and TRANSFUSE6; box 1) analysed nearly 30 000 patients who received transfusions, reporting neither benefit nor harm from cells with different storage durations. These results should provide adequate reassurance that storage duration has no clinical impact.…”

mentioning

confidence: 99%

“…TRANSFUSE 6 (a superiority trial)— Enrolled 4664 critically ill patients (of whom 4919 completed the trial in the primary outcome) who received a red blood cell transfusion. No significant difference was found between the freshest available and standard issue groups for the main outcome of 90 days mortality (storage 11.8(5.3) days v 22.4(7.5); % of 30 day mortality 19% v 18%).…”

mentioning

confidence: 99%

See 1 more Smart Citation