Safety of stored blood among chief concerns for transfusion medicine community

Medical literature addresses possible adverse effects with older red cells; delivery of oxygen

2011-04-15

(Press-News.org) In light of recent studies that suggest the use of stored blood during transfusions may cause adverse effects in patients, the National Heart, Lung, and Blood Institute (NHLBI) funded a number of research projects to examine the safety of transfusing older red cells and the impact of stored blood on respiratory gases. These papers discussing potential adverse effects of stored blood and related concerns for oxygen delivery by transfusion are now available online in TRANSFUSION, a journal published by Wiley-Blackwell on behalf of AABB.

Blood banks are responsible for the collection, testing, and storage of blood to be used by the nearly 5 million Americans who receive blood transfusions annually. When patients experience a loss of blood due to illness or trauma, transfusions of whole blood or individual components (red cells, white cells, platelets, and plasma) are administered to restore blood volume to adequate levels. According to the 2007 National Blood Collection and Utilization Survey (NBCUS) Report, 14.7 million units of blood were administered in the U.S., with a total of 72,000 transfusion-related adverse reactions in the prior year.

"The most critical issue facing transfusion medicine is whether or not stored (older) blood is less safe than fresher blood," explains Paul M. Ness, M.D., Director of Transfusion Medicine at Johns Hopkins Medical Institute in Baltimore, MD, and Editor-in-Chief of TRANSFUSION. "Although emerging infectious disease risks and transfusion reactions are important concerns, there is nothing more imperative to our patients than making sure the methods we use to collect and store red cells do not impair their transport of vital respiratory gases."

Current Food and Drug Administration (FDA) standards state that red cells may be stored under refrigeration for a maximum of 42 days, or frozen for up to ten years. NBCUS 2007 data reported the mean age of stored red cells at the time of transfusion was 16 days. Medical evidence, however, has not been able to conclusively determine if stored blood adversely affects patients' health. In one prior study, trauma patients who received red cells stored beyond two weeks had a significantly increased risk of mortality compared to those transfused with fresher blood (Weinberg et al., 2010). Conversely, a study by Edgren et al., analyzed close to 405,000 transfusions between 1995 and 2002 and found no significant association between age of blood and seven-day mortality.

Controlled clinical trials in cardiac surgery and intensive care units are under way, and are expected to provide the transfusion community with critical data regarding the adverse effects of stored blood use. "Findings from these trials will not be reported for several years," said Dr. Ness. "Our early publication of the NHLBI grant program studies provides the transfusion community with a head start in learning more about what makes stored blood old, and provides advance opportunity for commercial industry to develop improved methods of blood storage that will mitigate adverse effects in patients."

### These studies are published in TRANSFUSION. Media wishing to receive a PDF of the articles may contact healthnews@wiley.com.

Full Citations Editorial: "Does Transfusion of Stored Red Cells Cause Clinically Important Adverse Effects? A Critical Question in Search of an Answer and a Plan." Paul Ness. TRANSFUSION; Published Online: April 15, 2011 (DOI: 10.1111/j.1537-2995.2011.03121.x); Print Issue Date: April 2011. http://doi.wiley.com/10.1111/j.1537-2995.2011.03121.x

Editorial: "The 2010 Tibor Greenwalt Lecture The Air We Breathe--Three Vital Respiratory Gases and The Red Cell: Oxygen, Nitric Oxide, and Carbon Dioxide." Walter H. Dzik. TRANSFUSION; Published Online: April 15, 2011 (DOI: 10.1111/j.1537-2995.2011.03114.x); Print Issue Date: April 2011. http://doi.wiley.com/10.1111/j.1537-2995.2011.03114.x

Article: "Red Blood Cell Age and Potentiation of Transfusion-Related Pathology in Trauma Patients." Jordan A. Weinberg, Scott R. Barnum, and Rakesh P. Patel. TRANSFUSION; Published Online: April 15, 2011 (DOI: 10.1111/j.1537-2995.2011.03098.x); Print Issue Date: April 2011. http://doi.wiley.com/10.1111/j.1537-2995.2011.03098.x

Article: "New Frontiers in Transfusion Biology: Identification and Significance of Mediators of Morbidity and Mortality in Stored Red Blood Cells." Katie Grimshaw, Julie Sahler, Sherry L. Spinelli, Richard P. Phipps and Neil Blumberg.TRANSFUSION; Published Online: April 15, 2011 (DOI: 10.1111/j.1537-2995.2011.03095.x); Print Issue Date: April 2011. http://doi.wiley.com/10.1111/j.1537-2995.2011.03095.x

Article: "Microparticles in Stored Red Blood Cells as Potential Mediators of Transfusion Complications." Wenche Jy, Marco Ricci, Sherry Shariatmadar, Orlando Gomez- Marin, Lawrence H. Horstman,and Yeon S. Ahn. TRANSFUSION; Published Online: April 15, 2011 (DOI: 10.1111/j.1537-2995.2011.03099.x); Print Issue Date: April 2011. http://doi.wiley.com/10.1111/j.1537-2995.2011.03099.x

Article: "Storage Lesion: Role of Red Cell Breakdown." Daniel B. Kim-Shapiro, Janet Lee, Mark T. Gladwin. TRANSFUSION; Published Online: April 15, 2011 (DOI: 10.1111/j.1537-2995.2011.03100.x); Print Issue Date: April 2011. http://doi.wiley.com/10.1111/j.1537-2995.2011.03100.x

Article: "Properties of Stored RBCs: Understanding Immune and Vascular Reactivity." Philip C. Spinella, Rosemary L. Sparrow, John R. Hess, Philip J. Norris. TRANSFUSION; Published Online: April 15, 2011 (DOI: 10.1111/j.1537-2995.2011.03103.x); Print Issue Date: April 2011. http://doi.wiley.com/10.1111/j.1537-2995.2011.03103.x

Article: "Insufficient Nitric Oxide Bioavailability: A Hypothesis to Explain Adverse Effects of Red Blood Cell Transfusion." John D. Roback, Robert Neuman, Arshed Quyyumi, and Roy Sutliff. TRANSFUSION; Published Online: April 15, 2011 (DOI: 10.1111/j.1537-2995.2011.03094.x); Print Issue Date: April 2011. http://doi.wiley.com/10.1111/j.1537-2995.2011.03094.x

Article: "Harmful Effects of Transfusion of Older Stored Red Blood Cells: Iron And Inflammation." Eldad A. Hod and Steven L. Spitalnik. TRANSFUSION; Published Online: April 15, 2011 (DOI: 10.1111/j.1537-2995.2011.03096.x); Print Issue Date: April 2011. http://doi.wiley.com/10.1111/j.1537-2995.2011.03096.x

Article: "The Transfusion Problem: Role of Aberrant S-Nitrosylation." James D. Reynolds, Douglas T. Hess, and Jonathan S. Stamler. TRANSFUSION; Published Online: April 15, 2011 (DOI: 10.1111/j.1537-2995.2011.03097.x); Print Issue Date: April 2011. http://doi.wiley.com/10.1111/j.1537-2995.2011.03097.x

About the Journal TRANSFUSION is the official journal of AABB and the foremost publication in the world for new information regarding transfusion medicine. Written by and for members of AABB and other health-care workers, TRANSFUSION reports on the latest technical advances, discusses opposing viewpoints regarding controversial issues, and presents key conference proceedings. In addition to blood banking and transfusion medicine topics, TRANSFUSION presents submissions concerning tissue transplantation and hematopoietic, cellular, and gene therapies. For more information, please visit http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1537-2995/issues.

About AABB AABB (formerly the American Association of Blood Banks) is an international, not-for-profit association representing individuals and institutions involved in the field of transfusion medicine and cellular therapies. The association is committed to improving health by developing and delivering standards, accreditation and educational programs that focus on optimizing patient and donor care and safety. AABB membership consists of nearly 2,000 institutions and 8,000 individuals, including physicians, nurses, scientists, researchers, administrators, medical technologists and other health care providers. Members are located in more than 80 countries. For more information, please visit www.aabb.org.

About Wiley-Blackwell Wiley-Blackwell is the international scientific, technical, medical, and scholarly publishing business of John Wiley & Sons, with strengths in every major academic and professional field and partnerships with many of the world's leading societies. Wiley-Blackwell publishes nearly 1,500 peer-reviewed journals and 1,500+ new books annually in print and online, as well as databases, major reference works and laboratory protocols. For more information, please visit www.wileyblackwell.com or our new online platform, Wiley Online Library (wileyonlinelibrary.com), one of the world's most extensive multidisciplinary collections of online resources, covering life, health, social and physical sciences, and humanities.

ELSE PRESS RELEASES FROM THIS DATE:

Genital herpes more virulent in Africa than in US

2011-04-15

BOSTON, Mass. (April 15, 2011) — Strains of genital herpes in Africa are far more virulent than those in the United States, researchers at Harvard Medical School report, a striking insight into a common disease with important implications for preventing HIV transmission in a region staggered by the HIV/AIDS epidemic. The researchers arrived at this finding by testing mouse model strains of the disease against vaccine candidates. All vaccines were far more efficacious in abating the U.S. strain. The researchers say identification of the properties of the African viruses ...

Jefferson researchers unlock key to personalized cancer medicine using tumor metabolism

2011-04-15

PHILADELPHIA—Identifying gene mutations in cancer patients to predict clinical outcome has been the cornerstone of cancer research for nearly three decades, but now researchers at the Kimmel Cancer Center at Jefferson have invented a new approach that instead links cancer cell metabolism with poor clinical outcome. This approach can now be applied to virtually any type of human cancer cell. The researchers demonstrate that recurrence, metastasis, and poor clinical outcome in breast cancer patients can be identified by simply gene profiling cancer cells that are using ...

Secrets of a precision protein machine

2011-04-15

VIDEO: Much of the FEN1 structure was solved by Sakurai et al, but how FEN1 works was not apparent in the DNA-free structure. The presence of DNA appears to induce the... Click here for more information. DNA replication is critical to the life of all organisms, insuring that each new cell, as well as each new offspring, gets an accurate copy of the genome. Among the legions of proteins that do the work so essential to a cell's survival, the DNA-slicing "flap endonuclease" ...

Colorado Supreme Court to Review Wal-Mart Personal Injury Damages Issue

2011-04-15

The Colorado Supreme Court recently decided to review a 2010 Colorado Court of Appeals decision involving the collateral source rule. The central issue is whether a Colorado personal injury defendant can introduce evidence of the actual amount a health provider received for a plaintiff's injuries. Under common law, compensation or indemnity paid to an injured party by a collateral source (that is, not the alleged wrongdoer in the lawsuit) does not reduce the damages that could otherwise be recovered from the wrongdoer. In Crossgrove v. Wal-Mart Stores, Inc., a delivery ...

Crash rates may be higher for teen drivers who start school earlier in the morning

2011-04-15

DARIEN, IL – A study in the April 15 issue of the Journal of Clinical Sleep Medicine shows increased automobile crash rates among teen drivers who start school earlier in the morning. Results indicate that in 2008 the weekday crash rate for 16- to 18-year-olds was about 41 percent higher in Virginia Beach, Va., where high school classes began at 7:20 - 7:25 a.m., than in adjacent Chesapeake, Va., where classes started at 8:40 - 8:45 a.m. There were 65.8 automobile crashes for every 1,000 teen drivers in Virginia Beach, and 46.6 crashes for every 1,000 teen drivers in ...

A safer treatment could be realized for millions suffering from parasite infection

2011-04-15

A safer and more effective treatment for 10 million people in developing countries who suffer from infections caused by trypanosome parasites could become a reality thanks to new research from Queen Mary, University of London published today (15 April). Scientists have uncovered the mechanisms behind a drug used to treat African sleeping sickness and Chagas disease, infections caused by trypanosome parasites which result in 60,000 deaths each year. The study, appearing in the Journal of Biological Chemistry, investigated how the drug nifurtimox works to kill off the ...

NYC Bicyclists May Face New Laws, Challenges

2011-04-15

An editorial in the New York Post gave City Councilman Eric Ulrich a "Knucklehead Award" for his proposal to license all bicycles in New York City. Ulrich, from Queens (and the youngest serving member of the council at age 24), proposed the licensing system after receiving complaints from senior citizens who said, according to Ulrich, that bicyclists "scare the hell out of them." While some rogue cyclists may tarnish the reputation of all riders, cycling is up across the city, with Department of Transportation figures showing the number of everyday bicycle commuters ...

Blood test could predict metastasis risk in melanoma

2011-04-15

PHILADELPHIA — Scientists at Yale University have identified a set of plasma biomarkers that could reasonably predict the risk of metastasis among patients with melanoma, according to findings published in Clinical Cancer Research, a journal of the American Association for Cancer Research. "The rate at which melanoma is increasing is dramatic, and there is a huge number of patients under surveillance," said Harriet Kluger, M.D., associate professor of medicine at Yale University School of Medicine. "Our current method of surveillance includes periodic imaging, which creates ...

Study examines new treatment for recurrent urinary tract infections

2011-04-15

[EMBARGOED FOR APRIL 15, 2011] Urinary tract infections are common in women, costing an estimated $2.5 billion per year to treat in 2000 in the United States alone. These infections frequently recur, affecting 2 to 3 percent of all women. A depletion of vaginal lactobacilli, a type of bacteria, is associated with urinary tract infection risk, which suggests that replenishing these bacteria may be beneficial. Researchers conducted a double-blind placebo-controlled trial to investigate this theory. Their results are published in Clinical Infectious Diseases and now available ...

Federal Motor Carrier Safety Administration Proposes New EOBR Rules for Trucks

2011-04-15

The U.S. Department of Transportation's Federal Motor Carrier Safety Administration (FMCSA) has issued a regulatory proposal requiring interstate commercial truck and bus companies to install electronic on-board recorders (EOBRs) to monitor the number of hours their drivers are on the road. FMCSA proposes mandatory installation and use of EOBRs in all commercial motor vehicles (CMV) for which the use of Record of Duty Status (RODS) is currently required. EOBRs are devices attached to commercial vehicles that automatically record the number of hours drivers spend operating ...

Safety of stored blood among chief concerns for transfusion medicine community

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: