Addressing the question of the effect of RBC storage on clinical outcomes: the Red Cell Storage Duration Study...

Area of Science:

• Transfusion Medicine
• Hematology
• Critical Care Medicine

Background:

• The impact of red blood cell (RBC) storage duration on oxygen delivery capacity and patient outcomes is debated.
• Physiologically plausible hypotheses suggest stored RBCs may have impaired function, but clinical evidence is inconsistent.
• Existing studies show conflicting results regarding the association between longer RBC storage times and adverse patient outcomes.

Purpose of the Study:

• To definitively address the clinical equipoise surrounding RBC storage duration and its effect on patient outcomes.
• To investigate the impact of RBC storage duration in specific patient populations, including neonates, ICU patients, and those undergoing complex cardiac surgery.

Main Methods:

• Three multicenter, randomized, controlled trials are underway: the Age of Red Blood Cells in Premature Infants study, the Age of Blood Study (in ICU patients), and the Red Cell Storage Duration Study (RECESS).
• The RECESS trial randomizes patients undergoing complex cardiac surgery to receive RBCs stored for ≤10 days or ≥21 days.
• The primary outcome in RECESS is the change in the Multiple Organ Dysfunction Score (MODS) by day 7, with secondary outcomes including MODS at day 28, mortality, and organ-specific function.

Main Results:

• The abstract does not contain study results; it describes the design and planned outcomes of ongoing trials.
• The RECESS trial aims to enroll 1434 evaluable subjects (717 per arm).

Conclusions:

• The clinical significance of RBC storage duration requires further investigation through robust randomized controlled trials.
• These ongoing trials are designed to provide critical data to resolve the debate on RBC storage and transfusion practices.