Is there a difference between transfusing old vs fresh blood in critical illness

Clinical Center

Investigators

Linked publications & trials

Abstract

After a metaanalysis we published in the journal Transfusion suggested the age of stored blood may have a significant effect on survival after transfusion, we intiated a series of pre-clinical studies in our canine model of critical illness. Our initial study showed a significantly worse outcome if critically ill patients were transfused with old (42 day) vs. fresh (7 day) blood. We have also shown that old blood will not worsen a very severely ill or healthy patient but in a patient population with a 50-70% mortality, tranfusion of old blood significantly worsens outcome. We also found the age of blood that becomes harmful is likely between 14 and 28 days. In a therapeutic study, we should that washing stored blood (to wash out any accummilated harmful particles) with saline improves survival when transfusing old stored blood but worsens survival when transfusing washed fresh blood. Ongoing studies will narrow the window when the age of stored blood adversely affects survival and the role of the volume of transfusion. We are also pursuing the role of iron as a mechanism underlying the harmful effects of stored blood. This line of research has resulted in the publication of 5 papers to date.