It is quality not quantity

We knew all the time that  “newer blood” might be safer than “older blood.” There has been evidence to suggest that during storage, red blood cells undergo functional and structural changes which impair RBC function (termed “storage lesion”).

A retrospective study from Cleveland Clinic published in the NEJM examined outcomes of patients given red-cell transfusions during CABG surgery. Blood stored for more than 14 days prior to transfusion was considered “older blood” and blood stored less than 14 days was considered “newer blood.” Patients who received older blood had increased perioperative complications (25.9% vs. 22.4%), higher in-hospital mortality (2.8% vs. 1.7%), and decreased survival at one year. In recent years, there have been several studies that found improvement and benefit with conservative strategies of blood transfusions. An incremental increase of adverse outcomes has been observed with each additional unit of PRBC transfused. This new study suggests that it may not only be quantity, but the quality of blood we should be concerned with as well.