Effect of Transfusion of Red Blood Cells With Longer vs Shorter Storage Duration on Elevated Blood Lactate Levels in Children With Severe Anemia

Abstract

clinicaltrials.gov Identifier: NCT01586923.

Iron accelerates hemoglobin oxidation increasing mortality in vascular diseased guinea pigs following transfusion of stored blood

“…Prospective clinical trials in different patient populations have also not confirmed the initial findings of increased morbidity and mortality after stored RBC transfusion (6,7). These randomized trials reported that older stored blood compared with fresh blood did not alter clinical outcomes (6,7,10) or surrogate markers of tissue oxygenation (11) in patients undergoing cardiac surgery as well as in critically ill adults and infants.…”

Age before duty: the effect of storage duration on mortality after red blood cell transfusion

“…One reason for this is that these studies have been limited by small sample sizes. Another reason is that the definition of fresh blood and aged blood has been inconsistent across studies ( Table 1) (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Several articles have defined fresh blood as a function of time, ranging anywhere from 5 days (8) to 21 days (17), while others have taken a more practical approach, employing a "freshest available" policy (18,20).…”

“…The authors employed a "freshest available" approach to short-term storage, and "standard issue" policy to the long-term storage group. Median storage of pRBC units prior to transfusion was 11 days [interquartile ratio (IQR), [8][9][10][11][12][13][14][15] in the short-term group, as compared to 24 days (IQR 18-30) in the long-term group. There were no differences in in-hospital mortality between the two cohorts.…”

RBC storage lesions

“…5 Thrombospondin-5, also known as cartilage oligomeric matrix protein, binds to collagen II and IX and aggrecan to promote collagen fibril assembly and ECM formation. 6 Mutations in TSP5 lead to premature assembly of the ECM in the endoplasmic reticulum and cause the human dwarfing condition pseudoachondroplasia. 7 It will be important to determine whether or not the large morphologic changes in collagen RBC storage lesions For personal use only.…”

“…Several larger human randomized controlled trials have shown no effect of transfusing longer-stored RBCs. 6 In an e-Blood article associated with this issue, Reisz and colleagues use proteomics and metabolomics to elucidate RBC storage lesions. They were able to identify and follow the concentrations of normal and oxidized proteins.…”