Shelf Life of Blood Appears Shorter Than Thought

Decreased membrane deformability not readily reversible after transfusion, small study finds

FRIDAY, March 8 (HealthDay News) -- Red blood cells stored longer than three weeks begin to lose their flexibility, according to a small study published online Feb. 28 in Anesthesia & Analgesia.

Steven M. Frank, M.D., from Johns Hopkins University in Baltimore, and colleagues examined erythrocyte deformability in 16 posterior spinal fusion surgery patients, comparing those who required moderate transfusion (greater than or equal to five units erythrocytes) and those who received minimal transfusion (zero to four units erythrocytes). Samples were drawn directly from the blood storage bags before transfusion and from patients before and after transfusion (over three postoperative days). The elongation index measured using ektacytometry quantitatively assessed deformity.

The researchers found that erythrocyte deformability was significantly decreased compared to preoperative baseline in patients receiving moderate transfusion, but not after minimal transfusion. Over three postoperative days, these changes remained consistent. In erythrocytes stored for 21 days or less, deformability was significantly less than in those stored for more than 21 days or those drawn from patients preoperatively. Intermediate deformability was seen in cell-salvaged erythrocytes, which was greater than that of erythrocytes stored 21 days or more but less than that of erythrocytes stored less than 21 days.

"The findings demonstrate that increased duration of erythrocyte storage is associated with decreased cell membrane deformability and that these changes are not readily reversible after transfusion," the authors write.

One author disclosed financial ties to Terumo BCT and Fenwal Labs, both involved with blood storage.

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