Stored blood: how old is too old?

Area of Science:

• Hematology
• Transfusion Medicine
• Clinical Research

Background:

• Red blood cell (RBC) transfusion is a critical medical procedure.
• Current US regulations permit a maximum RBC storage duration of 42 days.
• Evidence suggests increased patient risk with RBCs stored near the upper limit.

Purpose of the Study:

• To evaluate the physiological effects of transfusing RBCs stored for six weeks compared to those stored for five weeks or less in healthy adults.

Main Methods:

• Healthy adult participants received one unit of RBCs.
• Comparison between RBCs stored for approximately six weeks versus five weeks or less.
• Assessment of iron handling, hemolysis markers, and non-transferrin-bound iron.

Main Results:

• RBCs stored for six weeks induced disruptions in iron metabolism.
• Increased extravascular hemolysis was observed with six-week stored RBCs.
• Circulating non-transferrin-bound iron was detected in recipients of older RBCs.

Conclusions:

• Transfusion of RBCs nearing the maximum storage limit is associated with adverse effects.
• Findings indicate potential harm related to iron dysregulation and hemolysis.
• Current maximum RBC storage durations warrant careful reevaluation.