Older Blood Used in Transfusions Raises Infection Risk

Most of us don’t think about blood. We just want it to stay where it belongs and do its job. Blood is the body’s transportation system, carrying oxygen and nutrients to the organs in our body that need them, and carrying away the waste products to be eliminated. In an average lifetime most people will never need a blood transfusion.

What about the individuals every year that need blood because of accidents, blood loss during surgery and long term illnesses which require continued transfusions? Where does the blood come from? Most blood in this country is donated, and there are specific rules for the donors, including age and health status. The majority of blood is donated through blood banks, community centers during blood drives, and through the Red Cross. Without the selflessness of these volunteers, people who really need blood could lose their lives.

The business of blood, donations, storage, and transfusion, is regulated by the Food and Drug Administration.  Blood cannot be used for patients if it has been stored over 42 days but recent findings may indicate that is too long.  According to Cooper University Hospital in New Jersey, after 29 days of storage, the risk of blood poisoning or pneumonia doubled in recipients. The possible reason is that after two weeks in storage the red blood cells in the blood start to undergo changes and begin to release chemicals call “cytokines.” The cytokines hinder immune function and high levels could make patients more susceptible to infection.

The study looked at 422 patients. A total of 57 patients developed an infection. The patients who developed an infection had received blood which had been stored on average of three and a half days longer than the other recipients. Patients who had received blood older than 28 days were more likely to develop an infection, and the more transfusions received the higher the chance of infection.

The research was led by Dr. David Gerber, who presented the results at the American College of Chest Physicians conference in Philadelphia, and said that any change to the storage time could lead to a blood shortage. He stated that more cautious use of the blood could help alleviate a reduced supply if there were a change in policy.

According to Dr. Richard J. Benjamin, chief medical officer of the American Red Cross, the study highlights “a need for controlled studies on the effect of the age of blood on patient outcomes.” But he noted that donated blood plays a key role in patient care and the potential benefits against the small risk of harm has to be considered.

With the advent of the AIDS epidemic and before improved testing for HIV, hepatitis and other infectious viruses those receiving blood wanted to know where it came from. It would appear that the current question has to be “How long has the blood been in storage?”