From the Journal archives: The red blood cell storage lesion: past, present, and future

This retrospective observational study was performed to determine if the age of transfused units of red blood cells (RBCs) was related to mortality. The study included 31 transfused patients admitted to the intensive care unit during 1992 with severe sepsis (i.e., sepsis associated with organ dysfunction, hypoperfusion, or hypotension).

Nineteen of 31 patients (61%) died. On average, non-survivors received older RBC units than survivors. In non-survivors, the median age of the units was 24 days (range 7-36 days), whereas the median age in survivors was 21 days (range 5-35 days). Analyzing outcomes according to different age categories revealed that survivors received 85% of units that were less than ten days old, whereas non-survivors received 76% of units that were more than 20 days old. These differences were statistically significant (P < 0.0001).

The authors concluded that the duration of storage of RBCs is directly related to the risk of mortality among transfused patients with severe sepsis. Recognizing the limitations of their small retrospective study that did not adjust for confounders, they also stated that further studies are needed to confirm or refute this association.