Additive solutions and processing procedures permit red cells to have a shelf-life of 42 days. However, red cells stored over time have altered deformability and biochemical changes which decrease survival and oxygen-carrying capacity. Retrospective studies have suggested that older blood may be associated with increased morbidity and mortality. However, a change in the shelf-life could have a significant impact on availability and inventory.
Dr. Dzik and the BEST collaborative published an article in the journal Transfusion modeling the demand factors associated with the age of blood at the time of transfusion to patients.
Here is Dr. Dzik on the primary finding of this study:
“The age of blood at the time of release from the bank to the patient depends on several factors including the blood types of the recipients and the level of intensity of health care that occurs at the hospital.”
The study also found that age of red cell release to patients was sensitive to age of blood when the hospital received it, restocking intervals, inventory size, and demand at the hospital. Hospitals transfusing large quantities of red cells or hospitals possessing sporadic, high-bleeding trauma cases must maintain ample inventories. If fresher red cells are found to be necessary, the inventory of blood products at hospitals may become imbalanced
Here is Dr. Sayers who wrote an accompanying editorial:
“I think the major challenge is going to be how many categories of patients do deserve fresher blood – if any? The preliminary evidence says that it’s not indicated, but if there are categories of patients, then blood programs and hospitals are going to have to ration what really is a very limited resource I doubt that all of their needs are going to be met, given competition between hospitals for a product that will be in short supply.”
The results from this study suggest that any substantial shortening in the expiration date of red blood cells will need to be substantially discussed by the transfusion medicine community and clinicians.
We’ll be back with another edition of Transfusion News on January 15th. Thanks for joining us.
1. Dzik WH, Beckman N, Murphy MF, Delaney M, Flanagan P, Fung M, Germain M, Haspel RL, Lozano M, Sacher R, Szczepiorkowski Z, Wendel S: Factors affecting red blood cell storage age at the time of transfusion. Transfusion 2013;53:3110-3119.