Red blood cell storage time and the outcome after coronary surgery

Area of Science:

• Cardiovascular Surgery
• Transfusion Medicine
• Critical Care Medicine

Background:

• The clinical significance of transfusing aged red blood cells (RBCs) after coronary artery bypass grafting (CABG) remains a subject of debate.
• Previous studies have yielded conflicting results regarding the impact of RBC storage duration on patient outcomes.

Purpose of the Study:

• To investigate the association between the storage duration of transfused RBCs and both immediate and late clinical outcomes in patients undergoing isolated CABG.
• To clarify the controversial impact of aged RBC transfusion on post-CABG patient recovery and survival.

Main Methods:

• A cohort of 819 patients undergoing isolated CABG who received 2-4 units of RBCs were analyzed.
• Data included perioperative transfusion details, RBC storage time (maximum 35 days), and adverse events.
• Statistical analyses included repeated-measure tests, propensity score-adjusted analyses, logistic regression, and proportional hazards models.

Main Results:

• Transfusion of RBCs stored for >14 days was not associated with significantly different postoperative C-reactive protein or creatinine levels compared to newer RBCs.
• Propensity score-adjusted analyses revealed similar immediate and late outcomes for patients receiving only newer RBCs versus those receiving only older RBCs or at least one unit of older RBCs.
• RBC median storage duration was not significantly associated with immediate adverse outcomes or late mortality after adjusting for the number of RBC units transfused.

Conclusions:

• In patients undergoing CABG with moderate bleeding, where the maximum RBC storage time is 35 days, the duration of RBC storage does not appear to influence immediate or late clinical outcomes.
• These findings suggest that RBCs stored up to 35 days can be safely transfused in the context of CABG without adversely affecting patient outcomes.