Perspectives on the impact of storage duration on blood quality and transfusion outcomes

BACKGROUND & OBJECTIVES Red blood cells (RBCs) may be stored up to 42 days before transfusion, per US and EU standards. Although there is ample evidence that RBCs undergo deleterious changes during storage, studies assessing outcomes relative to storage time report conflicting findings. This study investigated RBC storage duration perspectives and practices among blood banking and transfusion professionals. MATERIALS & METHODS A survey was administered at the American Association of Blood Banking annual meeting in October 2014 (N = 69). RESULTS On average, participants believed RBC storage should not exceed 34 days (median: 35; range: 1-52), and estimated that RBCs are typically stored 21 days before transfusion at their institutions (median: 20; range: 10-40). There was 97% agreement that minimizing/reversing changes during RBC storage may produce clinical benefits; however, 80% believed the research does not consistently demonstrate worse outcomes using older blood. Two-thirds agreed that RBC storage duration is a major concern, but 81% agreed most institutions are not pursuing measures to shorten storage. CONCLUSIONS This study found that many transfusion professionals believe RBCs should be stored for fewer than the 42 days currently allowed and that further efforts are warranted to abrogate changes in stored RBCs. These findings suggest a need for increased awareness of potential consequences of extended RBC storage and for strategies to maximize transfusion benefits.