Abstract
Background: The storage lesion is defined as the set of changes that occur in red blood cells (RBCs) during storage. Studies have shown that a prolonged storage period of RBCs is associated with increased destruction after transfusion. The aim of this study is to determine the impact of the storage lesion on the efficacy of RBC transfusions by comparing the mean rise in the hemoglobin of patients who received new vs old blood.Methods: We did a retrospective chart review of all patients who received a single unit of pure red blood cell (PRBC) transfusion in a three-month period. Patients with hemolytic anemia and active bleeding were excluded. The storage lesion was estimated by calculating the number of days to expiration on the day of transfusion. Median days to expiration was calculated to be 11 days. Patients were divided into two groups based on days to expiration. Group A included patients who received old blood (days to expiration: 0-11) and group B included patients who received new blood (days to expiration: 11-38). The mean rise in hemoglobin between the two groups was compared using the paired t-test.Results: The baseline characteristics of both groups were similar. There was no statistically significant difference in the mean rise in hemoglobin (1.01 vs 1.08- p-value 0.298), hematocrit (3.37 vs 3.61- p-value 0.249), and RBC count (0.42 vs 0.44- p-value 0.097) in the group that received old blood vs new blood, respectively.Conclusion: An RBC transfusion with a shorter storage period does not increase hemoglobin more than RBC with a longer storage period.
Highlights
The storage lesion refers to the set of biochemical and structural changes that occur during the storage of red blood cells (RBCs) [1]
Multiple trials have looked at the effect of the storage lesion on mortality and morbidity but little is known about its impact on the RBCs ability to raise post-transfusion hemoglobin
We hypothesize that if a relatively new pure red blood cell (PRBC) unit can achieve a higher rise in hemoglobin after transfusion, we can selectively transfuse new blood to patients requiring multiple transfusions and potentially limit the total number of transfusions required to reach a target hemoglobin
Summary
The storage lesion refers to the set of biochemical and structural changes that occur during the storage of red blood cells (RBCs) [1]. Earlier studies reported increased mortality associated with transfusing older blood, but recent trials have reported no such effect of the storage lesion in critically ill. Multiple trials have looked at the effect of the storage lesion on mortality and morbidity but little is known about its impact on the RBCs ability to raise post-transfusion hemoglobin. The storage lesion is defined as the set of changes that occur in red blood cells (RBCs) during storage. The aim of this study is to determine the impact of the storage lesion on the efficacy of RBC transfusions by comparing the mean rise in the hemoglobin of patients who received new vs old blood
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