Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jul 14;2015(7):CD009330.
doi: 10.1002/14651858.CD009330.pub2.

Prolonged storage of packed red blood cells for blood transfusion

Arturo J Martí-Carvajal  1 , Daniel Simancas-Racines, Barbra S Peña-González
Affiliations

Prolonged storage of packed red blood cells for blood transfusion

Arturo J Martí-Carvajal et al. Cochrane Database Syst Rev. .

Abstract

Background: A blood transfusion is an acute intervention, used to address life- and health-threatening conditions on a short-term basis. Packed red blood cells are most often used for blood transfusion. Sometimes blood is transfused after prolonged storage but there is continuing debate as to whether transfusion of 'older' blood is as beneficial as transfusion of 'fresher' blood.

Objectives: To assess the clinical benefits and harms of prolonged storage of packed red blood cells, in comparison with fresh, on recipients of blood transfusion.

Search methods: We ran the search on 1st May 2014. We searched the Cochrane Injuries Group Specialized Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE (OvidSP), Embase (OvidSP), CINAHL (EBSCO Host) and two other databases. We also searched clinical trials registers and screened reference lists of the retrieved publications and reviews. We updated this search in June 2015 but these results have not yet been incorporated.

Selection criteria: Randomised clinical trials including participants assessed as requiring red blood cell transfusion were eligible for inclusion. Prolonged storage was defined as red blood cells stored for ≥ 21 days in a blood bank. We did not apply limits regarding the duration of follow-up, or country where the study took place. We excluded trials where patients received a combination of short- and long-stored blood products, and also trials without a clear definition of prolonged storage.

Data collection and analysis: We independently performed study selection, risk of bias assessment and data extraction by at least two review authors. The major outcomes were death from any cause, transfusion-related acute lung injury, and adverse events. We estimated relative risk for dichotomous outcomes. We measured statistical heterogeneity using I(2). We used a random-effects model to synthesise the findings.

Main results: We identified three randomised clinical trials, involving a total of 120 participants, comparing packed red blood cells with ≥ 21 days storage ('prolonged' or 'older') versus packed red blood cells with < 21 days storage ('fresh'). We pooled data to assess the effect of prolonged storage on death from any cause. The confidence in the results from these trials was very low, due to the bias in their design and their limited sample sizes.The estimated effect of packed red blood cells with ≥ 21 days storage versus packed red blood cells with < 21 days storage for the outcome death from any cause was imprecise (5/45 [11.11%] versus 2/46 [4.34%]; RR 2.36; 95% CI 0.65 to 8.52; I(2): 0%, P = 0.26, very low quality of evidence). Trial sequential analysis, with only two trials, shows that we do not yet have convincing evidence that older packed red blood cells induce a 20% relative risk reduction of death from any cause compared with fresher packed red blood cells. No trial included other outcomes of interest specified in this review, namely transfusion-related acute lung injury, postoperative infections, and adverse events. The safety profile is unknown.

Authors' conclusions: Recognising the limitations of the review, relating to the size and nature of the included trials, this Cochrane Review provides no evidence to support or reject the use of packed red blood cells for blood transfusion which have been stored for ≥ 21 days ('prolonged' or 'older') compared with those stored for < 21 days ('fresh'). These results are based on three small single centre trials with high risks of bias. There is insufficient evidence to determine the effects of fresh or older packed red blood cells for blood transfusion. Therefore, we urge readers to interpret the trial results with caution. The results from four large ongoing trials will help to inform future updates of this review.

PubMed Disclaimer

Conflict of interest statement

Daniel Simancas: None known.

Barbra Peña‐González: None known.

Arturo Martí‐Carvajal: None known.

Figures

1
1
Study flow diagram.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies. Three studies are included in this review.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
4
4
Trial sequential analysis on death from any cause in two trials of < 21 day old versus ≥ 21 day old packed red blood cells. Trial sequential analysis of two trials of < 21 day old versus ≥ 21 day old packed red blood cells on death from any cause based on the diversity‐adjusted required information size (DARIS) of 584 patients. This DARIS was calculated based upon a proportion of patients with death from any cause of 22.2% in the control group; a RRR of 40% in the experimental intervention group; an alpha (α) of 5%; and a beta (β) of 20%. The cumulative Z‐curve (blue line) did not cross the conventional alpha of 5% (green line) after two trials. It implies that there is a random error. The cumulative Z‐curve did not reach the futility area, which is not even drawn by the program. Presently, only 2.91% (17/584) of the DARIS has been obtained. Had we calculated the DARIS based on a more realistic RRR such as 20% or less, the obtained evidence would represent a much smaller part of the DARIS.
1.1
1.1. Analysis
Comparison 1 <21 days old versus ≥21 days old packed red blood cells, Outcome 1 Death from any cause.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD009330

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

Dhabangi 2013 {published data only}
    1. Dhabangi A, Mworozi E, Lubega IR, Cserti‐Gazdewich CM, Maganda A, Dzik WH. The effect of blood storage age on treatment of lactic acidosis by transfusion in children with severe malarial anaemia: a pilot, randomized, controlled trial. Malaria Journal 2013;12:55. [PUBMED: 23388470] - PMC - PubMed
    1. Dzik WH. A prospective study of RBC transfusion in children with severe anemia. http://clinicaltrials.gov/ct2/show/record/NCT01586923. [Accessed in 21 February 2014].
Schulman 2002 {published data only}
    1. Schulman CI, Nathe K, Brown M, Cohn SM. Impact of age of transfused blood in the trauma patient. The Journal of Trauma 2002;52(6):1224‐5. [PUBMED: 12045660] - PubMed
Walsh 2004 {published data only}
    1. Walsh TS, Mcardle F, Mclellan SA, Maciver C, Maginnis M, Prescott RJ, et al. Does the storage time of transfused red blood cells influence regional or global indexes of tissue oxygenation in anemic critically ill patients?. Critical Care Medicine 2004;32(2):364‐71. [PUBMED: 14758149] - PubMed

References to studies excluded from this review

ARIPI 2012 {published data only}
    1. Fergusson D, Hutton B, Hogan DL, Lebel L, Blajchman MA, Ford JC, et al. The age of red blood cells in premature infants (ARIPI) randomized controlled trial: study design. Transfusion Medicine Reviews 2009;23(1):55‐61. [PUBMED: 19056034] - PubMed
    1. Fergusson DA, Hebert P, Hogan DL, LeBel L, Rouvinez‐Bouali N, Smyth JA, et al. Effect of fresh red blood cell transfusions on clinical outcomes in premature, very low‐birth‐weight infants: the ARIPI randomized trial. JAMA 2012;308(14):1443‐51. [PUBMED: 23045213] - PubMed
Aubron 2012 {published data only}
    1. Aubron C, Syres G, Nichol A, Bailey M, Board J, Magrin G, et al. A pilot feasibility trial of allocation of freshest available red blood cells versus standard care in critically ill patients. Transfusion 2012;52(6):1196‐202. [PUBMED: 22082281] - PubMed
Bennett‐Guerrero 2009 {published data only}
    1. Bennett‐Guerrero E, Stafford‐Smith M, Waweru PM, Bredehoeft SJ, Campbell ML, Haley NR, et al. A prospective, double‐blind, randomized clinical feasibility trial of controlling the storage age of red blood cells for transfusion in cardiac surgical patients. Transfusion 2009;49(7):1375‐83. [PUBMED: 19389021] - PubMed
Cartotto 2014 {published data only}
    1. Cartotto R, Yeo C, Camacho F, Callum J. Does the storage age of transfused blood affect outcome in burn patients?. Journal of Burn Care & Research 2014;35(2):186‐97. [PUBMED: 23799480] - PubMed
Cunha 2004 {published data only}
    1. Cunha D, Kopelman B, Santos A, Guinsburg R, Terzian C, Kuwano S, et al. Can red blood cells stored up to 30 days be safely transfused to very low birthweight infants?. Pediatric Research 2004;55:68.
Dunn 2012 {published data only}
    1. Dunn LK, Thiele RH, Ma JZ, Sawyer RG, Nemergut EC. Duration of red blood cell storage and outcomes following orthotopic liver transplantation. Liver Transplantation 2012;18(4):475‐81. [PUBMED: 22238247] - PubMed
Eshleman 1994 {published data only}
    1. Eshleman JR, Akinbi H, Pleasure J, Asakura T, Magee D, Smith L, et al. Prospective double‐blind study of small volume neonatal transfusion with RBCs up to 35 days old. Transfusion. 1994; Vol. 34:32S.
Fernandes 2005 {published data only}
    1. Fernandes da Cunha DH, Nunes Dos Santos AM, Kopelman BI, Areco KN, Guinsburg R, Araujo Peres C, et al. Transfusions of CPDA‐1 red blood cells stored for up to 28 days decrease donor exposures in very low‐birth‐weight premature infants. Transfusion Medicine 2005;15(6):467‐73. [PUBMED: 16359417] - PubMed
Gomez‐Lesmes 2014 {published data only}
    1. Gomez‐Lesmes SP, Tornero E, Martinez‐Pastor JC, Pereira A, Marcos M, Soriano A. Length of storage of transfused red blood cells and risk of prosthetic joint infection after primary knee arthroplasty. The Journal of Arthroplasty 2014;29(10):2016‐20. [PUBMED: 25015758] - PubMed
Hebert 2005 {published data only}
    1. Hebert PC, Chin‐Yee I, Fergusson D, Blajchman M, Martineau R, Clinch J, et al. A pilot trial evaluating the clinical effects of prolonged storage of red cells. Anesthesia and Analgesia 2005;100(5):1433‐8. [PUBMED: 15845701] - PubMed
Heddle 2012 {published data only}
    1. Heddle NM, Cook RJ, Arnold DM, Crowther MA, Warkentin TE, Webert KE, et al. The effect of blood storage duration on in‐hospital mortality: a randomized controlled pilot feasibility trial. Transfusion 2012;52(6):1203‐12. [PUBMED: 22257314] - PubMed
Juffermans 2012 {published data only}
    1. Juffermans NP, Vlaar AP, Prins DJ, Goslings JC, Binnekade JM. The age of red blood cells is associated with bacterial infections in critically ill trauma patients. Blood Transfusion 2012;10(3):290‐5. [PUBMED: 22395349] - PMC - PubMed
Kadar 2013 {published data only}
    1. Kadar A, Chechik O, Katz E, Blum I, Meghiddo G, Salai M, et al. The effects of 'old' red blood cell transfusion on mortality and morbidity in elderly patients with hip fractures‐‐a retrospective study. Injury 2013;44(6):747‐50. [PUBMED: 23481314] - PubMed
Kaukonen 2013 {published data only}
    1. Kaukonen KM, Vaara ST, Pettilä V, Bellomo R, Tuimala J, Cooper DJ, et al. Age of red blood cells and outcome in acute kidney injury. Critical Care 2013;17(5):R222. [PUBMED: 24093554] - PMC - PubMed
Kekre 2013 {published data only}
    1. Kekre N, Mallick R, Allan D, Tinmouth A, Tay J. The impact of prolonged storage of red blood cells on cancer survival. PloS One 2013;8(7):e68820. [PUBMED: 23874777] - PMC - PubMed
Kor 2012 {published data only}
    1. Kor DJ, Kashyap R, Weiskopf RB, Wilson GA, Buskirk CM, Winters JL, et al. Fresh red blood cell transfusion and short‐term pulmonary, immunologic, and coagulation status: a randomized clinical trial. American Journal of Respiratory and Critical Care Medicine 2012;185(8):842‐50. [PUBMED: 22281833] - PMC - PubMed
Liu 1994 {published data only}
    1. Liu EA, Mannino FL, Lane TA. Prospective, randomized trial of the safety and efficacy of a limited donor exposure transfusion program for premature neonates. The Journal of Pediatrics 1994;125(1):92‐6. [PUBMED: 8021796] - PubMed
Marcus 1985 {published data only}
    1. Marcus RE, Wonke B, Bantock HM, Thomas MJ, Parry ES, Taite H, et al. A prospective trial of young red cells in 48 patients with transfusion‐dependent thalassaemia. British Journal of Haematology 1985;60(1):153‐9. [PUBMED: 4005175] - PubMed
Min 2014 {published data only}
    1. Min JJ, Bae JY, Kim TK, Hong DM, Hwang HY, Kim KB, et al. Association between red blood cell storage duration and clinical outcome in patients undergoing off‐pump coronary artery bypass surgery: a retrospective study. BMC Anesthesiology 2014;14:95. [PUBMED: 25352766] - PMC - PubMed
Rogers 2014 {published data only}
    1. Rogers MA, Micic D, Blumberg N, Young VB, Aronoff DM. Storage duration of red blood cell transfusion and Clostridium difficile infection: a within person comparison. PloS one 2014;9(2):e89332. [PUBMED: 24586694] - PMC - PubMed
Strauss 1996 {published data only}
    1. Strauss RG, Burmeister LF, Johnson K, James T, Miller J, Cordle DG, et al. AS‐1 red cells for neonatal transfusions: a randomized trial assessing donor exposure and safety. Transfusion 1996;36(10):873‐8. [PUBMED: 8863773] - PubMed
Strauss 1999 {published data only}
    1. Strauss RG, Burmeister L, James T, Miller J, Johnson K, Bell E. A randomized trial of fresh versus stored red blood cells for neonatal transfusions. Transfusion 1994;34(10S):65S. - PubMed
    1. Strauss RG, Cordle DG, Quijana J, Goeken NE. Comparing alloimmunization in preterm infants after transfusion of fresh unmodified versus stored leukocyte‐reduced red blood cells. Journal of Pediatric Hematology Oncology 1999;21(3):224‐30. [PUBMED: 10363856] - PubMed
Wallis 2005 {published data only}
    1. Wallis JP, Wells AW, Babb RG, Stainsbuy D, Hamilton PJ. Effect of storage age of transfused blood on 48 hour Hb increment and recovery of 2,3 DPG in haematology patients. British Journal of Haematology 2005;129(Suppl 1):1.
Wasser 1989 {published data only}
    1. Wasser MN, Houbiers JG, D'Amaro J, Hermans J, Huysmans HA, Konijnenburg GC, et al. The effect of fresh versus stored blood on post‐operative bleeding after coronary bypass surgery: a prospective randomized study. British Journal of Haematology 1989;72(1):81‐4. [PUBMED: 2786735] - PubMed
Weinberg 2013 {published data only}
    1. Weinberg JA, MacLennan PA, Vandromme‐Cusick MJ, Magnotti LJ, Kerby JD, Rue LW 3rd, et al. The deleterious effect of red blood cell storage on microvascular response to transfusion. Journal of Trauma and Acute Care Surgery 2013;75(5):807‐12. [PUBMED: 24158198] - PMC - PubMed

References to studies awaiting assessment

Damiani 2015 {published data only}
    1. Damiani E, Adrario E, Luchetti MM, Scorcella C, Carsetti A, Mininno N, et al. Plasma‐free hemoglobin and microvascular response to fresh or old blood transfusion in septic patients. PLoS One 2015;10(5):e0122655. [PUBMED: 25932999] - PMC - PubMed
Klein 2014 {published data only}
    1. Klein G. Transfusion of older vs fresher blood in the context of infection. 33rd International Congress of the International Society of Blood Transfusion, in Conjunction with the 33rd Congress of the KSBT and the 2014 Congress of the Korean Hematology Societies; 2014 May 31 ‐ June 05; Seoul South Korea. Vox sanguinis. 2014. - PubMed
Lacroix 2011 {published data only}
    1. Lacroix J, Hébert P, Fergusson D, Tinmouth A, Blajchman MA, Callum J, et al. The Age of Blood Evaluation (ABLE) randomized controlled trial: study design. Transfusion Medicine Reviews 2011;25(3):197‐205. [PUBMED: 21550205] - PubMed
Lacroix 2015 {published data only}
    1. Lacroix J, Hebert PC, Fergusson DA, Tinmouth A, Cook DJ, Marshall JC, et al. Age of transfused blood in critically ill adults. New England Journal of Medicine 2015;9(15):1410‐8. [PUBMED: 25853745] - PubMed
Neuman 2013 {published data only}
    1. Neuman RB, Menon V, Karatela S, Newman J, Sher S, Ashraf K, et al. Endothelial dysfunction precipitated by transfusion of storage‐aged but not fresh red blood cells. 62nd Annual Scientific Session of the American College of Cardiology and i2 Summit: Innovation in Intervention, ACC.13; 2013 Mar 09‐11; San Francisco, CA, USA. 2013:E2066.
Neuman 2015 {published data only}
    1. Neuman R, Hayek S, Rahman A, Poole JC, Menon V, Sher S, et al. Effects of storage‐aged red blood cell transfusions on endothelial function in hospitalized patients. Transfusion Practice 2015;55(4):782‐90. - PMC - PubMed
Redlin 2014 {published data only}
    1. Redlin M, Habazettl H, Schoenfeld H, Kukucka M, Boettcher W, Kuppe H, et al. Red blood cell storage duration is associated with various clinical outcomes in pediatric cardiac surgery. Transfusion Medicine and Hemotherapy 2014;41(2):146‐51. [PUBMED: 24847191] - PMC - PubMed
Steiner 2015 {published data only}
    1. Steiner ME, Ness PM, Assmann SF, Triulzi DJ, Sloan SR, Delaney M, et al. Effects of red‐cell storage duration on patients undergoing cardiac surgery. New England Journal of Medicine 2015;372(15):1419‐29. [PUBMED: 25853746] - PMC - PubMed
Thurer 2013 {published data only}
    1. Thurer RL, Precopio T, Popovsky MA. Storage age of blood transfused in the US: Is it changing? AABB Annual Meeting and CTTXPO. 2013 October 12‐15; Denver. Transfusion. 2013.
Von Heymann 2013 {published data only}
    1. Heymann C. Impact of the age of red blood cells and the outcome after cardiac surgery. 28th Annual Meeting of the European Association of Cardiothoracic Anaesthesiologists, EACTA; 2013 June 6‐8; Barcelona. Applied cardiopulmonary pathophysiology. 2013.

References to ongoing studies

ACTRN12612000453886 {published data only}
    1. ACTRN12612000453886. The effect of transfusion of fresher blood versus standard care on 28 and 90 day mortality in patients admitted to ICU. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=1261... 2012.
ISRCTN08118744 {published data only}
    1. ISRCTN08118744. INforming Fresh versus Old Red cell Management (INFORM): a large simple phase III randomized controlled trial. http://www.isrctn.com/ISRCTN08118744 2012.
NCT00458783 {published data only}
    1. NCT00458783. Red Cell Storage Duration and Outcomes in Cardiac Surgery. http://clinicaltrials.gov/show/NCT00458783 2007.
NTR2662 {published data only}
    1. NTR2662. Age of Blood evaluation, resuscitation in the critically ill. http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2662 2010.

Additional references

Almac 2007
    1. Almac E, Ince C. The impact of storage on red cell function in blood transfusion. Best Practice & Research. Clinical Anaesthesiology 2007;21(2):195‐208. [PUBMED: 17650772] - PubMed
Aubron 2014
    1. Aubron C, Bailey M, McQuilten Z, Pilcher D, Hegarty C, Martinelli A, et al. Duration of red blood cells storage and outcome in critically ill patients. Journal of Critical Care 2014;29(3):476.e1‐8. [PUBMED: 24559574] - PubMed
Aucar 2009
    1. Aucar JA, Isaak E, Anthony D. The effect of red blood cell age on coagulation. American Journal of Surgery 2009;198(6):900‐4. [PUBMED: 19969149] - PubMed
Balshem 2011
    1. Balshem H, Helfand M, Schunemann HJ, Oxman AD, Kunz R, Brozek J, et al. GRADE guidelines: 3. Rating the quality of evidence. Journal of clinical epidemiology 2011;64(4):401‐6. [PUBMED: 21208779] - PubMed
Basch 2012
    1. Basch E, Aronson N, Berg A, Flum D, Gabriel S, Goodman SN, et al. Methodological standards and patient‐centeredness in comparative effectiveness research: the PCORI perspective. JAMA 2012;307(15):1636‐40. [PUBMED: 22511692] - PubMed
Basran 2006
    1. Basran S, Frumento RJ, Cohen A, Lee S, Du Y, Nishanian E, et al. The association between duration of storage of transfused red blood cells and morbidity and mortality after reoperative cardiac surgery. Anesthesia and Analgesia 2006;103(1):15‐20. [PUBMED: 16790618] - PubMed
Bennett‐Guerrero 2009
    1. Bennett‐Guerrero E, Stafford‐Smith M, Waweru PM, Bredehoeft SJ, Campbell ML, Haley NR, et al. A prospective, double‐blind, randomized clinical feasibility trial of controlling the storage age of red blood cells for transfusion in cardiac surgical patients. Transfusion 2009;49(7):1375‐83. [PUBMED: 19389021] - PubMed
Bosman 2008
    1. Bosman GJ, Werre JM, Willekens FL, Novotný VM. Erythrocyte ageing in vivo and in vitro: structural aspects and implications for transfusion. Transfusion Medicine 2008;18(6):335‐47. [PUBMED: 19140816] - PubMed
Brok 2008
    1. Brok J, Thorlund K, Gluud C, Wetterslev J. Trial sequential analysis reveals insufficient information size and potentially false positive results in many meta‐analyses. Journal of Clinical Epidemiology 2008;61(8):763‐9. [PUBMED: 18411040] - PubMed
Brok 2009
    1. Brok J, Thorlund K, Wetterslev J, Gluud C. Apparently conclusive meta‐analyses may be inconclusive‐‐Trial sequential analysis adjustment of random error risk due to repetitive testing of accumulating data in apparently conclusive neonatal meta‐analyses. International Journal of Epidemiology 2009;38(1):287‐98. [PUBMED: 18824466] - PubMed
Brozek 2011
    1. Brozek JL, Akl EA, Compalati E, Kreis J, Terracciano L, Fiocchi A, et al. Grading quality of evidence and strength of recommendations in clinical practice guidelines part 3 of 3. The GRADE approach to developing recommendations. Allergy 2011;66(5):588‐95. [PUBMED: 21241318] - PubMed
Clarke 2007
    1. Clarke M. Standardising outcomes for clinical trials and systematic reviews. Trials 2007;8:39. [PUBMED: 18039365] - PMC - PubMed
Cohen 2013
    1. Cohen B, Matot I. Aged erythrocytes: a fine wine or sour grapes?. British Journal of Anaesthesia 2013;111(Suppl 1):i62‐70. [PUBMED: 24335400] - PubMed
Concise Medical Dictionary 2011
    1. Martin E. Concise Medical Dictionary. 8th Edition. New York City: Oxford University Press, 2011.
Deeks 2003
    1. Deeks JJ, Dinnes J, D'Amico R, Sowden AJ, Sakarovitch C, Song F, et al. Evaluating non‐randomised intervention studies. Health Technology Assessment 2003;7(27):1‐173. [PUBMED: 14499048] - PubMed
Dunne 2004
    1. Dunne JR, Malone DL, Tracy JK, Napolitano LM. Allogenic blood transfusion in the first 24 hours after trauma is associated with increased systemic inflammatory response syndrome (SIRS) and death. Surgical Infections 2004;5(4):395‐404. [PUBMED: 15744131] - PubMed
Edna 1994
    1. Edna TH, Bjerkeset T, Svinsas M, Drogset JO, Skreden K. Association between transfusion of stored blood and bacterial infective complications after biliary operations. The European Journal of Surgery 1994;160(6‐7):357‐62. [PUBMED: 7948354] - PubMed
Edna 1998
    1. Edna TH, Bjerkeset T. Association between transfusion of stored blood and infective bacterial complications after resection for colorectal cancer. The European Journal of Surgery 1998;164(6):449‐56. [PUBMED: 9696446] - PubMed
Flegel 2014
    1. Flegel WA, Natanson C, Klein HG. Does prolonged storage of red blood cells cause harm?. British Journal of Haematology 2014;165(1):3‐16. [PUBMED: 24460532] - PMC - PubMed
Frenzel 2009
    1. Frenzel T, Westphal‐Varghese B, Westphal M. Role of storage time of red blood cells on microcirculation and tissue oxygenation in critically ill patients. Current Opinion in Anaesthesiology 2009;22(2):275‐80. [PUBMED: 19390254] - PubMed
Gauvin 2010
    1. Gauvin F, Spinella PC, Lacroix J, Choker G, Ducruet T, Karam O, et al. Association between length of storage of transfused red blood cells and multiple organ dysfunction syndrome in pediatric intensive care patients. Transfusion 2010;50(9):1902‐13. [PUBMED: 20456697] - PubMed
Giangrande 2000
    1. Giangrande PL. The history of blood transfusion. British Journal of Haematology 2000;110(4):758‐67. [PUBMED: 11054057] - PubMed
Glynn 2010
    1. Glynn SA. The red blood cell storage lesion: a method to the madness. Transfusion 2010;50(6):1164‐9. [PUBMED: 20598098] - PubMed
Goldberg 2012
    1. Goldberg AD, Kor DJ. State of the art management of transfusion‐related acute lung injury (TRALI). Current Pharmaceutical Design 2012;18(22):3273‐84. [PUBMED: 22621274] - PubMed
Goldman 2005
    1. Goldman M, Webert KE, Arnold DM, Freedman J, Hannon J, Blajchman MA. Proceedings of a consensus conference: towards an understanding of TRALI. Transfusion Medicine Reviews 2005;19(1):2‐31. [PUBMED: 15830325] - PubMed
GRADEpro 2008 [Computer program]
    1. Brozek J, Oxman A, Schünemann H. GRADEpro. Version 3.2 for Windows. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group, 2008.
Greer 2010
    1. Greer SE, Rhynhart KK, Gupta R, Corwin HL. New developments in massive transfusion in trauma. Current Opinion in Anaesthesiology 2010;23(2):246‐50. [PUBMED: 20104173] - PubMed
Guyatt 2011
    1. Guyatt GH, Oxman AD, Kunz R, Atkins D, Brozek J, Vist G, et al. GRADE guidelines: 2. Framing the question and deciding on important outcomes. Journal of Clinical Epidemiology 2011;64(4):395‐400. [PUBMED: 21194891] - PubMed
Guyatt 2011a
    1. Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction‐GRADE evidence profiles and summary of findings tables. Journal of Clinical Epidemiology 2011;64(4):383‐94. [PUBMED: 21195583] - PubMed
Guyatt 2011b
    1. Guyatt GH, Oxman AD, Vist G, Kunz R, Brozek J, Alonso‐Coello P, et al. GRADE guidelines: 4. Rating the quality of evidence‐‐study limitations (risk of bias). Journal of Clinical Epidemiology 2011;64(4):407‐15. [PUBMED: 21247734] - PubMed
Guyatt 2011c
    1. Guyatt GH, Oxman AD, Sultan S, Glasziou P, Akl EA, Alonso‐Coello P, et al. GRADE guidelines: 9. Rating up the quality of evidence. Journal of Clinical Epidemiology 2011;64(12):1311‐6. [PUBMED: 21802902] - PubMed
Guyatt 2011d
    1. Guyatt GH, Oxman AD, Kunz R, Woodcock J, Brozek J, Helfand M, et al. GRADE guidelines: 8. Rating the quality of evidence‐‐indirectness. Journal of Clinical Epidemiology 2011;64(12):1303‐10. [PUBMED: 21802903] - PubMed
Guyatt 2011e
    1. Guyatt GH, Oxman AD, Kunz R, Woodcock J, Brozek J, Helfand M, et al. GRADE guidelines: 7. Rating the quality of evidence‐‐inconsistency. Journal of Clinical Epidemiology 2011;64(12):1294‐302. [PUBMED: 21803546] - PubMed
Guyatt 2011f
    1. Guyatt GH, Oxman AD, Kunz R, Brozek J, Alonso‐Coello P, Rind D, et al. GRADE guidelines 6. Rating the quality of evidence‐‐imprecision. Journal of Clinical Epidemiology 2011;64(12):1283‐93. [PUBMED: 21839614] - PubMed
Guyatt 2011g
    1. Guyatt GH, Oxman AD, Montori V, Vist G, Kunz R, Brozek J, et al. GRADE guidelines: 5. Rating the quality of evidence‐‐publication bias. Journal of Clinical Epidemiology 2011;64(12):1277‐82. [PUBMED: 21802904] - PubMed
Hendrickson 2009
    1. Hendrickson JE, Hillyer CD. Noninfectious serious hazards of transfusion. Anesthesia and Analgesia 2009;108(3):759‐69. [PUBMED: 19224780] - PubMed
Hess 2006
    1. Hess JR. An update on solutions for red cell storage. Vox Sanguinis 2006;91(1):13‐9. [PUBMED: 16756596] - PubMed
Hess 2010
    1. Hess JR. Red cell changes during storage. Transfusion and Apheresis Science 2010;43(1):51‐9. [PUBMED: 20558107] - PubMed
Hess 2010a
    1. Hess JR. Red cell storage. Journal of Proteomics 2010;73(3):368‐73. [PUBMED: 19914410] - PubMed
Higgins 2003
    1. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. BMJ 2003;327:557‐60. [PUBMED: 12958120] - PMC - PubMed
Higgins 2011
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration. Available from www.cochrane‐handbook.org.
Ho 2003
    1. Ho J, Sibbald WJ, Chin‐Yee IH. Effects of storage on efficacy of red cell transfusion: when is it not safe?. Critical Care Medicine 2003;31(12 Suppl):S687‐97. [PUBMED: 14724467] - PubMed
Hod 2010
    1. Hod EA, Zhang N, Sokol SA, Wojczyk BS, Francis RO, Ansaldi D, et al. Transfusion of red blood cells after prolonged storage produces harmful effects that are mediated by iron and inflammation. Blood 2010;115(21):4284‐92. [PUBMED: 20299509] - PMC - PubMed
Hod 2011
    1. Hod EA, Brittenham GM, Billote GB, Francis RO, Ginzburg YZ, Hendrickson JE, et al. Transfusion of human volunteers with older, stored red blood cells produces extravascular hemolysis and circulating non‐transferrin‐bound iron. Blood 2011;15(118):6675‐82. [PUBMED: 22021369] - PMC - PubMed
Hopewell 2010
    1. Hopewell S, Clarke M, Higgins JPT (editors). Core reporting of outcomes in effectiveness trials. Cochrane Methods 2010;Suppl 1:1‐29. [ISSN 2044‐4702]
ICH‐GCP 1997
    1. International Conference on Harmonisation Expert Working Group. International Conference on Harmonisation of technical requirements for registration of pharmaceuticals for human use. ICH harmonised tripartite guideline. Guideline for good clinical practice 1997 CFR & ICH Guidelines. Vol. 1, PA 19063‐2043, USA: Barnett International/PAREXEL, 1997.
Ioannidis 2010
    1. Ioannidis JP. The art of getting it wrong. Research Synthesis Methods 2010;1(3‐4):169‐84. - PubMed
Jakobsen 2013
    1. Jakobsen JC, Gluud C. The necessity of randomized clinical trials. British Journal of Medicine & Medical Research 2013;3(4):1453‐68.
Keller 2002
    1. Keller ME, Jean R, LaMorte WW, Millham F, Hirsch E. Effects of age of transfused blood on length of stay in trauma patients: a preliminary report. The Journal of Trauma 2002;53(5):1023‐5. [PUBMED: 12435963] - PubMed
Koch 2008
    1. Koch CG, Li L, Sessler DI, Figueroa P, Hoeltge GA, Mihaljevic T, et al. Duration of red‐cell storage and complications after cardiac surgery. New England Journal of Medicine 2008;358(12):1229‐39. [PUBMED: 18354101] - PubMed
Leal‐Noval 2001
    1. Leal‐Noval SR, Rincón‐Ferrari MD, García‐Curiel A, Herruzo‐Avilés A, Camacho‐Laraña P, Garnacho‐Montero J, et al. Transfusion of blood components and postoperative infection in patients undergoing cardiac surgery. Chest 2001;119(5):1461‐8. [PUBMED: 11348954] - PubMed
Leal‐Noval 2003
    1. Leal‐Noval SR, Jara‐López I, García‐Garmendia JL, Marín‐Niebla A, Herruzo‐Avilés A, Camacho‐Laraña P, et al. Influence of erythrocyte concentrate storage time on postsurgical morbidity in cardiac surgery patients. Anesthesiology 2003;98(4):815‐22. [PUBMED: 12657840] - PubMed
Leal‐Noval 2008
    1. Leal‐Noval SR, Munoz‐Gomez M, Arellano‐Orden V, Marin‐Caballos A, Amaya‐Villar R, Marin A, et al. Impact of age of transfused blood on cerebral oxygenation in male patients with severe traumatic brain injury. Critical Care Medicine 2008;36(4):1290‐6. [PUBMED: 18379257] - PubMed
Lefebvre 2011
    1. Lefebvre C, Manheimer E, Glanville J. Chapter 6: Searching for studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Lelubre 2009
    1. Lelubre C, Piagnerelli M, Vincent JL. Association between duration of storage of transfused red blood cells and morbidity and mortality in adult patients: myth or reality?. Transfusion 2009;49(7):1384‐94. [PUBMED: 19453985] - PubMed
Maani 2009
    1. Maani CV, DeSocio PA, Holcomb JB. Coagulopathy in trauma patients: what are the main influence factors?. Current Opinion in Anaesthesiology 2009;22(2):255‐60. [PUBMED: 19300245] - PubMed
Malone 2003
    1. Malone DL, Dunne J, Tracy JK, Putnam AT, Scalea TM, Napolitano LM. Blood transfusion, independent of shock severity, is associated with worse outcome in trauma. Journal of Trauma 2003;54(5):898‐905. [PUBMED: 12777902] - PubMed
Murrell 2005
    1. Murrell Z, Haukoos JS, Putnam B, Klein SR. The effect of older blood on mortality, need for ICU care, and the length of ICU stay after major trauma. The American Surgeon 2005;71(9):781‐5. [PUBMED: 16468518] - PubMed
Mynster 2000
    1. Mynster T, Nielsen HJ. The impact of storage time of transfused blood on postoperative infectious complications in rectal cancer surgery. Danish RANX05 Colorectal Cancer Study Group. Scandinavian Journal of Gastroenterology 2000;35(2):212‐7. [PUBMED: 10720122] - PubMed
Mynster 2001
    1. Mynster T, Nielsen HJ. Storage time of transfused blood and disease recurrence after colorectal cancer surgery. Diseases of the Colon and Rectum 2001;44(7):955‐64. [PUBMED: 11496075] - PubMed
Offner 2002
    1. Offner PJ, Moore EE, Biffl WL, Johnson JL, Silliman CC. Increased rate of infection associated with transfusion of old blood after severe injury. Archives of Surgery 2002;137(6):711‐6. [PUBMED: 12049543] - PubMed
Porta 2008
    1. Porta M. Dictionary of Epidemiology. Fifth edition. New York: Oxford University Press, 2008.
Purdy 1997
    1. Purdy FR, Tweeddale MG, Merrick PM. Association of mortality with age of blood transfused in septic ICU patients. Canadian Journal of Anaesthesia 1997;44(12):1256‐61. [PUBMED: 9429042] - PubMed
Qu 2015
    1. Qu L, Triulzi DJ. Clinical effects of red blood cell storage. Cancer Control 2015;22(1):26‐37. [PUBMED: 25504276] - PubMed
RevMan 2011 [Computer program]
    1. The Nordic Cochrane Centre. Review Manager (RevMan). Version 5.3. Copenhagen: The Cochrane Collaboration, 2011.
Robinson 2005
    1. Robinson WP 3rd, Ahn J, Stiffler A, Rutherford EJ, Hurd H, Zarzaur BL, et al. Blood transfusion is an independent predictor of increased mortality in nonoperatively managed blunt hepatic and splenic injuries. Journal of Trauma 2005;58(3):437‐44. [PUBMED: 15761334] - PubMed
Selby 2012
    1. Selby JV, Beal AC, Frank L. The Patient‐Centered Outcomes Research Institute (PCORI) national priorities for research and initial research agenda. JAMA 2012;307(15):1583‐4. [PUBMED: 22511682] - PubMed
Sparrow 2015
    1. Sparrow RL. Red blood cell storage duration and trauma. Transfusion Medicine Reviews 2015;29(2):120‐6. [PUBMED: 25573415] - PubMed
Spinella 2009
    1. Spinella PC, Carroll CL, Staff I, Gross R, Quay J, Keibel L, et al. Duration of red blood cell storage is associated with increased incidence of deep vein thrombosis and in‐hospital mortality in patients with traumatic injuries. Critical Care Medicine 2009;13(5):R151. [PUBMED: 19772604] - PMC - PubMed
Stahel 2009
    1. Stahel PF, Moore EE, Schreier SL, Flierl MA, Kashuk JL. Transfusion strategies in postinjury coagulopathy. Current Opinion in Anaesthesiology 2009;22(2):289‐98. [PUBMED: 19390256] - PubMed
Sterne 2011
    1. Sterne JAC, Egger M, Moher D (editors). Chapter 10: Addressing reporting biases. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Intervention. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org, Version 5.1.0 (updated March 2011).
Stowell 2010
    1. Stowell CP. Effects of storage on the biology and clinical efficacy of the banked red blood cell. Transfusion and Apheresis Science 2010;43(1):45‐7. [PUBMED: 20554477] - PubMed
Sullivan 2007
    1. Sullivan MT, Cotten R, Read EJ, Wallace EL. Blood collection and transfusion in the United States in 2001. Transfusion 2007;47(3):385‐94. [PUBMED: 17319817] - PubMed
Sweeney 2009
    1. Sweeney J, Kouttab N, Kurtis J. Stored red blood cell supernatant facilitates thrombin generation. Transfusion 2009;49(8):1569‐79. [PUBMED: 19413726] - PubMed
Theusinger 2009
    1. Theusinger OM, Spahn DR, Ganter MT. Transfusion in trauma: why and how should we change our current practice?. Current Opinion in Anaesthesiology 2009;22(2):305‐12. [PUBMED: 19390257 ] - PubMed
Thorlund 2009
    1. Thorlund K, Devereaux PJ, Wetterslev J, Guyatt G, Ioannidis JP, Thabane L, et al. Can trial sequential monitoring boundaries reduce spurious inferences from meta‐analyses?. International Journal of Epidemiology 2009;38(1):276‐86. [PUBMED: 18824467] - PubMed
Thorlund 2011 [Computer program]
    1. Thorlund K, Engstrøm J, Wetterslev J, Brok J, Imberger G, Gluud C. User manual for trial sequential analysis (TSA). Version Available from www.ctu.dk/tsa. Copenhagen, Denmark: Copenhagen Trial Unit, Centre for Clinical Intervention Research, 2011.
Tien 2007
    1. Tien H, Nascimento B Jr, Callum J, Rizoli S. An approach to transfusion and hemorrhage in trauma: current perspectives on restrictive transfusion strategies. Canadian Journal of Surgery 2007;50(3):202‐9. [PUBMED: 17568492] - PMC - PubMed
Tinmouth 2006
    1. Tinmouth A, Fergusson D, Yee IC, Hébert PC, ABLE Investigators, Canadian Critical Care Trials Group. Clinical consequences of red cell storage in the critically ill. Transfusion 2006;46(11):2014‐27. [PUBMED: 17076859] - PubMed
Triulzi 2010
    1. Triulzi DJ, Yazer MH. Clinical studies of the effect of blood storage on patient outcomes. Transfusion and Apheresis Science 2010;43(1):95‐106. [PUBMED: 20656558] - PubMed
Tsai 2010
    1. Tsai AG, Hofmann A, Cabrales P, Intaglietta M. Perfusion vs. oxygen delivery in transfusion with "fresh" and "old" red blood cells: the experimental evidence. Transfusion and Apheresis Science 2010;43(1):69‐78. [PUBMED: 20646963] - PMC - PubMed
Vamvakas 1999
    1. Vamvakas EC, Carven JH. Transfusion and postoperative pneumonia in coronary artery bypass graft surgery: effect of the length of storage of transfused red cells. Transfusion 1999;39(7):701‐10. [PUBMED: 10413277] - PubMed
Vamvakas 2000
    1. Vamvakas EC, Carven JH. Length of storage of transfused red cells and postoperative morbidity in patients undergoing coronary artery bypass graft surgery. Transfusion 2000;40(1):101‐9. [PUBMED: 10644819] - PubMed
Vamvakas 2002
    1. Vamvakas EC, Carven JH. Exposure to allogeneic plasma and risk of postoperative pneumonia and/or wound infection in coronary artery bypass graft surgery. Transfusion 2002;42(1):107‐13. [PUBMED: 11896321] - PubMed
Vamvakas 2006
    1. Vamvakas EC. Pneumonia as a complication of blood product transfusion in the critically ill: transfusion‐related immunomodulation (TRIM). Critical Care Medicine 2006;34(5 Suppl):151‐9. [PUBMED: 16617260] - PubMed
Vamvakas 2010
    1. Vamvakas EC. Meta‐analysis of clinical studies of the purported deleterious effects of "old" (versus "fresh") red blood cells: are we at equipoise?. Transfusion 2010;50(3):600‐10. [PUBMED: 20042031] - PubMed
Van De Watering 2013
    1. Watering LMG. Age of blood: does older blood yield poorer outcomes?. Current Opinion in Hematology 2013;20(6):526‐32. [PUBMED: 24104414] - PubMed
Vandromme 2009
    1. Vandromme MJ, McGwin G Jr, Marques MB, Kerby JD, Rue LW 3rd, Weinberg JA. Transfusion and pneumonia in the trauma intensive care unit: an examination of the temporal relationship. The Journal of Trauma 2009;67(1):97‐101. [PUBMED: 19590316] - PubMed
Watering 2006
    1. Watering L van de, Lorinser J, Versteegh M, Westendord R, Brand A. Effects of storage time of red blood cell transfusions on the prognosis of coronary artery bypass graft patients. Transfusion 2006;46(10):1712‐8. [PUBMED: 17002627] - PubMed
Weinberg 2008a
    1. Weinberg JA, McGwin G Jr, Griffin RL, Huynh VQ, Cherry SA 3rd, Marques MB, et al. Age of transfused blood: an independent predictor of mortality despite universal leukoreduction. The Journal of Trauma 2008;65(2):279‐82. [PUBMED: 18695462 ] - PubMed
Wetterslev 2008
    1. Wetterslev J, Thorlund K, Brok J, Gluud C. Trial sequential analysis may establish when firm evidence is reached in cumulative meta‐analysis. Journal of Clinical Epidemiology 2008;61(1):64‐75. [PUBMED: 18083463] - PubMed
Wetterslev 2009
    1. Wetterslev J, Thorlund K, Brok J, Gluud C. Estimating required information size by quantifying diversity in random‐effects model meta‐analyses. BMC Medical Research Methodology 2009;9:86. [PUBMED: 20042080] - PMC - PubMed
Wienberg 2008b
    1. Weinberg JA, McGwin G Jr, Marques MB, Cherry SA 3rd, Reiff DA, Kerby JD, et al. Transfusions in the less severely injured: does age of transfused blood affect outcomes?. The Journal of Trauma 2008;65(4):794‐8. [PUBMED: 18849793] - PubMed
Wood 2008
    1. Wood L, Egger M, Gluud LL, Schulz KF, Juni P, Altman DG, et al. Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta‐epidemiological study. BMJ 2008;336(7644):601‐5. [PUBMED: 18316340] - PMC - PubMed
Yap 2008
    1. Yap CH, Lau L, Krishnaswamy M, Gaskell M, Yii M. Age of transfused red cells and early outcomes after cardiac surgery. The Annals of Thoracic Surgery 2008;86(2):554‐9. [PUBMED: 18640333] - PubMed
Zallen 1999
    1. Zallen G, Offner PJ, Moore EE, Blackwell J, Ciesla DJ, Gabriel J, et al. Age of transfused blood is an independent risk factor for post injury multiple organ failure. American Journal of Surgery 1999;178(6):570‐2. [PUBMED: 10670874] - PubMed
Zavala 2006
    1. Zavala D, Martí A, Peña‐Martí G, Comunián G. Sheet to enter data for performing a Cochrane review [Computer program]. Universidad de Carabobo, Valencia, Venezuela 2006.
Zimrin 2009
    1. Zimrin AB, Hess JR. Current issues relating to the transfusion of stored red blood cells. Vox Sanguinis 2009;96(2):93‐103. [PUBMED: 19152602] - PubMed
Zimring 2013
    1. Zimring JC. Fresh versus old blood: are there differences and do they matter?. Hematology/The Education Program of the American Society of Hematology 2013;2013:651‐5. [PUBMED: 24319246] - PubMed

Publication types

LinkOut - more resources