Abstract
IntroductionThe duration of red blood cell (RBC) storage before transfusion may alter RBC function and supernatant and, therefore, influence the incidence of complications or even mortality.MethodsA MEDLINE search from 1983 to December 2012 was performed to identify studies reporting age of transfused RBCs and mortality or morbidity in adult patients.ResultsFifty-five studies were identified; most were single-center (93%) and retrospective (64%), with only a few, small randomized studies (eight studies, 14.5%). The numbers of subjects included ranged from eight to 364,037. Morbidity outcomes included hospital and intensive care unit (ICU) length of stay (LOS), infections, multiple organ failure, microcirculatory alterations, cancer recurrence, thrombosis, bleeding, vasospasm after subarachnoid hemorrhage, and cognitive dysfunction. Overall, half of the studies showed no deleterious effects of aged compared to fresh blood on any endpoint. Eleven of twenty-two (50%) studies reported no increased mortality, three of nine (33%) showed no increased LOS with older RBCs and eight of twelve (66%) studies showed no increased risks of organ failure. Ten of eighteen (55%) studies showed increased infections with transfusion of older RBCs. The considerable heterogeneity among studies and numerous methodological flaws precluded a formal meta-analysis.ConclusionsIn this systematic review, we could find no definitive argument to support the superiority of fresh over older RBCs for transfusion.
Highlights
The duration of red blood cell (RBC) storage before transfusion may alter RBC function and supernatant and, influence the incidence of complications or even mortality
In a recent review of 45 observational studies that had reported the impact of transfusion on outcomes in different patient groups (trauma; general, cardiac, orthopedic and neurosurgical; acute coronary syndrome; intensive care (ICU) patients), RBC transfusion was an independent predictor of death, infectious complications and acute respiratory distress syndrome (ARDS) [3]
A small proportion of the studies were randomized trials (n = 8, 14.5%); the eight randomized studies had fewer included patients and, in the majority, physiological variables were reported as the primary outcome measure (n = 6 studies) (Table 3)
Summary
The duration of red blood cell (RBC) storage before transfusion may alter RBC function and supernatant and, influence the incidence of complications or even mortality. ○ Proinflammatory cytokines (IL-1beta, IL-6, IL-8, TNF-alpha) and complement. ○ Biologically active lipids such as platelet-activating factor (PAF) [14] ○ Free hemoglobin prone to scavenge nitric oxide (NO) of the recipient (together with Hb-containing microparticles) [109]. ○ Heme and iron [12] with potential redox injuries, cytotoxicity and inflammation
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
