New insights have been reported on the safety of transfusion with blood that has been stored for some time.
Currently, blood is stored for up to 42 days before transfusion. However, there is the risk that biochemical, structural, and functional changes during storage may cause a "hypercoagulable state", or a tendency to cause clotting, according to the Canadian researchers involved in the latest study.
Dr Michael DeGroote and colleagues at McMaster University, Ontario, Canada, took a closer look at the risk. They write in The New England Journal of Medicine on Monday (24 October) that: "Previous studies suggest prolonged blood storage is associated with an increased risk of cardiovascular events."
They add that many trials have been restricted to high-risk populations and "have not been powered to detect small but clinically important differences in mortality".
So they carried out a trial of 20,858 hospitalised patients at six hospitals in four countries. Participants all had type A or O blood, to allow comparisons between large enough groups of similar patients. They received red-cell transfusions with blood which had been stored for about 13 days (short-term storage group) or about 24 days (long-term storage group).
Among the short-term storage group 9.1% died, compared with 8.7% in the long-term storage group. Mortality rates were also similar regardless of storage duration in three high-risk subgroups - patients undergoing cardiovascular surgery, those admitted to intensive care, and those with cancer
"Among patients in a general hospital population, there was no significant difference in the rate of death among those who underwent transfusion with the freshest available blood and those who underwent transfusion according to the standard practice of transfusing the oldest available blood," say the team.
Dr DeGroote added: "This study reassures us that ageing is not bad - even for blood."
Heddle, N. M. et al. Effect of Short-Term vs. Long-Term Blood Storage on Mortality after Transfusion. New England Journal of Medicine 24 October 2016 doi: 10.1056/NEJMoa1609014
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