Does prolonged storage of red blood cells cause harm?

Flegel, Willy A.; Natanson, Charles; Klein, Harvey G.

doi:10.1111/bjh.12747

Cited by 100 publications

(103 citation statements)

References 116 publications

(161 reference statements)

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“…The in vitro RBC storage lesions include a wide range of cell abnormalities, affecting cell deformability and adhesion, oxygen delivery and free iron and microparticle production. These changes have been alleged to impair nitric oxide availability, immune regulation, inflammatory response and coagulation [20]. Despite the different storage times, in our preliminary findings, there were no differences in acute and delayed reactions between UCB and adult RBCs.…”

Section: Discussionmentioning

confidence: 51%

Allogeneic Umbilical Cord Blood Red Cell Concentrates: An Innovative Blood Product for Transfusion Therapy of Preterm Infants

Bianchi¹,

Giannantonio

Spartano³

et al. 2014

Neonatology

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Background: Preterm infants often receive blood transfusions early in life. In this setting, umbilical cord blood (UCB) might be safer than adult blood (A) with respect to infectious and immunologic threats. Objectives: To evaluate, as a first objective, the feasibility of fulfilling transfusion needs of preterm infants with allogeneic UCB red blood cell (RBC) concentrates and, as a secondary objective, to assess the safety of allogeneic cord blood transfusions. Methods: At the Neonatal Intensive Care Unit and the UNICATT Cord Blood Bank of ‘A. Gemelli' Hospital in Rome, a prospective study was carried out over a 1-year period, enrolling newborns with gestational age ≤30 weeks and/or birth weight ≤1,500 g requiring RBC transfusions within the first 28 days of life. At first transfusion, patients were assigned to receive UCB-RBCs or A-RBCs depending on the availability of ABO-Rh(D)-matched UCB-RBC units. The same regimen (UCB-RBC or A-RBC units) was thereafter maintained, unless ABO-Rh(D)-matched UCB-RBC units were not available. Results: Overall, 23 UCB-RBC units were transfused to 9 patients; the requests for UCB-RBC units were met in 45% of patients at the first transfusion and in 78% at the subsequent transfusions. At a median follow-up of 57 days (range 6-219), no acute or delayed transfusion-related adverse events occurred. Hematocrit gain after transfusion and time intervals between transfusions were similar in the UCB-RBC and A-RBC group, as well. Conclusions: Transfusing allogeneic UCB-RBC units in preterm infants appears a feasible and safe approach, although the transfusion needs of our study population were not completely covered. More data are necessary to validate this novel transfusion practice. © 2014 S. Karger AG, Basel

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Section: Discussionmentioning

confidence: 51%

Allogeneic Umbilical Cord Blood Red Cell Concentrates: An Innovative Blood Product for Transfusion Therapy of Preterm Infants

Bianchi¹,

Giannantonio

Spartano³

et al. 2014

Neonatology

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“…However, once blood donation has occurred it must be stored, and RBCs are known to undergo a series of physical and biochemical changes during storage, which are collectively known as "storage lesion." [13][14][15] These changes include degradation of erythrocytic 2,3-diphosphoglycerate (2,3-DPG), which diminishes the binding affinity of RBCs for oxygen.…”

Section: Discussionmentioning

confidence: 99%

“…Although the exact mechanism responsible for this is unknown, it is thought that structural, biochemical and immunologic changes occur within RBCs during their storage (also known as "storage lesion") and that these changes limit the benefits of pRBC transfusions. [13][14][15] Previous studies investigating the age of transfused blood in patients with traumatic injury have yielded inconsistent results. [16][17][18] To our knowledge, no systematic review currently exists that exclusively examines the impact of the age of transfused RBCs on mortality in the trauma patient population, although other patient populations have been investigated.…”

mentioning

confidence: 99%

Impact of the age of stored blood on trauma patient mortality: a systematic review

et al. 2015

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Background:The impact of the age of stored red blood cells on mortality in patients sustaining traumatic injuries requiring transfusion of blood products is unknown. The objective of this systematic review was to identify and describe the available literature on the use of older versus newer blood in trauma patient populations. Methods:We searched PubMed, Embase, Lilac and the Cochrane Database for published studies comparing the transfusion of newer versus older red blood cells in adult patients sustaining traumatic injuries. Studies included for review reported on trauma patients receiving transfusions of packed red blood cells, identified the age of stored blood that was transfused and reported patient mortality as an end point. We extracted data using a standardized form and assessed study quality using the Newcastle-Ottawa Scale.Results: Seven studies were identified (6780 patients) from 3936 initial search results. Four studies reported that transfusion of older blood was independently associated with increased mortality in trauma patients, while 3 studies did not observe any increase in patient mortality with the use of older versus newer blood. Three studies associated the transfusion of older blood with adverse patient outcomes, including longer stay in the intensive care unit, complicated sepsis, pneumonia and renal dys function. Studies varied considerably in design, volumes of blood transfused and def initions applied for old and new blood. Conclusion:The impact of the age of stored packed red blood cells on mortality in trauma patients is inconclusive. Future investigations are warranted.Contexte : On ne connaît pas l'incidence de la durée de stockage des globules rouges sur la mortalité des patients atteints de lésions traumatiques qui ont besoin de transfu sions de produits sanguins. L'objectif de cette revue systématique était de trouver et d'analyser la documentation scientifique qui compare les transfusions de sang chez les patients adultes victimes de trauma en fonction de la durée de stockage du sang.Méthodes : Nous avons effectué des recherches sur PubMed, Embase et Lilac et dans la Cochrane Database of Systematic Reviews. Les études retenues portaient sur des transfusions de concentré de globules rouges chez les patients atteints de lésions traumatiques, tenaient compte de la durée de stockage du sang transfusé et faisaient état des décès de patients. Nous avons extrait les données à l'aide d'un formulaire nor malisé et évalué la qualité des études selon l'échelle Newcastle-Ottawa.Résultats : Nous avons sélectionné 7 études (totalisant 6780 patients) parmi les 3936 ré sultats de la recherche initiale. D'un côté, 4 études rapportaient que la transfu sion de sang dont la durée de stockage était longue était indépendamment associée à l'augmentation de la mortalité chez les patients atteints de lésions traumatiques; de l'autre, 3 études ne faisaient état d'aucune augmentation de la mortalité en fonction de la durée de stockage du sang transfusé. Trois études associaient la transfusion de sang s...

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“…However, 10-25% of donor RBCs are cleared from the circulation of transfused recipients within 24 h [1]. In the Netherlands, RBC concentrates (RCCs) may be stored up to 35 days at 2-6 °C in saline-adenine-guanine-mannitol (SAGM) before transfusion, which is more conservative than in most countries [2]. During storage, RBCs undergo several biochemical and structural changes, collectively known as ‘storage lesion' [3,4].…”

Section: Introductionmentioning

confidence: 99%

Complement Deposition and IgG Binding on Stored Red Blood Cells Are Independent of Storage Time

Thielen

Meulenbroek

Baas

et al. 2018

Transfus Med Hemother

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Background: In the Netherlands, red blood cells (RBCs) are allowed to be stored up to 35 days at 2-6 °C in saline-adenine-glucose-mannitol (SAGM). During storage, RBCs undergo several changes that are collectively known as storage lesion. We investigated to what extent complement deposition and antibody binding occurred during RBC storage and investigated phagocytic uptake in vitro. Methods: RBCs were stored for different lengths of time at 2-6 °C in SAGM. Complement deposition and antibody binding were assessed upon storage and after incubation with serum. M1- and M2-type macrophages were generated from blood monocytes to investigate RBC phagocytosis. Results: No complement deposition was directly observed on stored RBCs, while incubation of RBCs with serum resulted in variable donor-dependent C3 deposition and IgG binding, both independent of storage time. Only 1-4% phagocytosis of stored RBCs by macrophages was observed. Conclusion: RBCs are susceptible to complement deposition and antibody binding independent of storage time. Limited phagocytic uptake by macrophages was observed in vitro.

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Does prolonged storage of red blood cells cause harm?

Cited by 100 publications

References 116 publications

Allogeneic Umbilical Cord Blood Red Cell Concentrates: An Innovative Blood Product for Transfusion Therapy of Preterm Infants

Allogeneic Umbilical Cord Blood Red Cell Concentrates: An Innovative Blood Product for Transfusion Therapy of Preterm Infants

Impact of the age of stored blood on trauma patient mortality: a systematic review

Complement Deposition and IgG Binding on Stored Red Blood Cells Are Independent of Storage Time

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