NHLBI to fund research into storage lesion in donated blood
Posted Aug 16 2010 4:30am
This is a bit "old news" but worth relaying. In late June, the National Heart, Lung and Blood Institute announced the funding of nine grants to explore the effect of storage time on donated blood. This is timely given recent studies that suggest increased risk of adverse cardiovascular and other organ events in people who received blood transfusions in which the storage time was greater than two weeks.
Current FDA guidelines permit liquid RBCs to be stored for up to 42 days (longer if the blood is frozen)--but the average unit of RBCs is transfused after 16 days' storage. We at my institution consider an outdated RBC product (which is thus wasted) to be an exceptional event and call for a "root cause analysis" when this occurs--which fortunately is extremely rare. (Plateletpheresis products are a different story for different reasons.) Blood banks and transfusion services are between Scylla and Charybdis here: there is a chronic shortage of donated blood in the U.S. so any shortening of acceptable storage life would further exacerbate that shortage BUT there is the critical imperative to provide safe blood.
THe storage lesion in banked blood refers to the metabolic changes that occur in the RBCs during storage as well as the effects of hemolysis and shortened RBC survival with storage. This results in the formation of RBC microparticles, release of free hemoglobin, and loss of RBC enzymatic functions--which not results in an ineffective or suboptimal therapeutic effect of the transfusion but also can cause widespread systemic deleterious effects.
These will be the first research projects to systematically examine collection, preparation, and storage practices as they relate to the RBC storage lesion.