Conserver les globules rouges pour la transfusion

Abstract

AbstractNinety million patients receive a red blood cell transfusion every year. This procedure requires to store red blood cells (RBC) between donation and transfusion to the recipient, to allow quality control and better flow management. Numerous technical improvements in recent decades now allow refrigerated storage of RBC concentrates for 42 days before use. During this 6-week-long period, a series of modifications that alter RBC have been described, collectively referred as the storage «lesion». These alterations increase with storage duration and is responsible for the early post-transfusion clearance of a portion of the transfused RBC (on average 18 %), reducing transfusion yield. The impact of storage duration on transfusion safety has been widely debated in recent years and, while the safety of standard care management seems to be established, the question of the safety of RBC stored for more than 35 days is still controversial. In Europe, the only quality criterion for RBC concentrates is hemolysis at 42 days, which should not exceed 0.8 %, but this parameter has not been correlated with transfusion efficacy. New markers, including storage-related morphological changes, may better correlate with transfusion yield.