Older stored blood as safe as fresher blood for transfusions in critically ill adults

Posted October 02, 2017

The age of transfused blood cells does not impact patient survival rates among critically ill adults, according to findings published in the New England Journal of Medicine.

The findings also show fewer transfusion reactions, including fever, with older blood - and in the most severely ill patients, the transfusion of older blood was associated with fewer deaths.

The results of the clinical trial entitled TRANSFUSE will help end speculation that fresher blood may be superior for critically ill patients.

“The findings of our trial confirm that the current duration of storage of red blood cells for transfusion is both safe and optimal,” said Professor Alastair Nichol, Chair of Critical Care Medicine in University College Dublin and Consultant Invensivist in St Vincent’s University Hospital who headed-up the Irish part of the trial.

“In fact, older blood appears to be like a good red wine, in that, it’s a little better with some age,” he added.

In most hospitals, the routine practice is to allocate the oldest available compatible blood for a transfusion. However, concerns about changes in the red blood cells for transfusion during storage have seen some doctors request fresher blood for specific patients. They have also encouraged some blood transfusion services to change their blood storage practices under the belief that “fresh must be best”.

“Blood banks around the world will not need to change systems and storage practices in the mistaken belief that fresher blood is better for critically ill patients,” explained Professor Nichol.

The TRANSFUSE trial was led by researchers from the Australian and New Zealand Intensive Care Research Centre at Monash University in Melbourne. It involved 4,919 patients from 59 hospital intensive care units across five countries including Australia, New Zealand, Ireland, Finland and Saudi Arabia. In Ireland, the study was funded by the Health Research Board.

“Irish participation in this study shows that the findings are applicable to practices here,” said Dr Stephen Field, Medical and Scientific Director of the Irish Blood Transfusion Service, who provided support to the trail.

“This study confirms that our current practice and protocols are consistent with the best evidence available. This will help increase available blood stocks and collection processes remain cost effective and do not require any change,” he concluded.

“This is a powerful demonstration of how research can directly inform clinical practice, improve patient outcomes and minimise costs,” said Dr Mairead O’Driscoll, Interim Chief Executive at the Health Research Board.

The Irish part of the study was coordinated by the Irish Critical Care Clinical Trials Network and supported by the Irish Critical Care- Clinical Trials Group. In Ireland St Vincent’s University Hospital, St James Hospital, Beaumont Hospital, Galway University Hospital, Cork university Hospital, Limerick university Hospital intensive care units participated.

The Australian National Health and Medical Research Council, Australian Red Cross Blood Service, Health Research Council of New Zealand, and the Health Research Board in Ireland funded the trial. The Australian and Finish Red Cross Blood Services, New Zealand Blood Service, Irish Blood Transfusion service and the Blood Bank of King Abdulaziz Medical City, Riyadh, Saudi Arabia provided support.

By: Dominic Martella, UCD University Relations