Blood Transfusions for Surgery: Is Newer Blood Always Better?

According to the American Red Cross, the shelf life for blood products varies by type. Here are their guidelines on how long blood can be stored: Platelets must be used within 5 days of donation. Red blood cells may be stored under refrigeration for a maximum of 42 days. Frozen red blood cells can last up to 10 years, but because of the high cost involved, only a small portion of the blood supply can be frozen. Plasma is generally frozen and must be used within one year.

Studies performed this summer indicate that patients may heal more quickly and fully if they receive newer blood. However, the oldest blood is used first to ensure that blood doesn't go bad. The new donations are stored and categorized so that they will be used only after all the previous units of that particular type of blood has been used.

Blood is expensive to process and store, so simply throwing out older blood isn't an option. Blood shortages already occur on a regular basis and lowering the amount of time that blood is viable will create more shortages. However, if this theory that newer blood is better, would it be safe to continue to offer the older blood units?

So far, some of the findings that point to the need for further study show that patients who get older blood spend more time on ventilators and in ICUs than patients who received newer blood. The risk for blood clots post-surgery also seems to be higher for those who received older blood.

The Cleveland Clinic found these trends when looking at the records of 6,000 heart surgery patients: "...those who received blood that was more than two weeks old were slightly more likely to die, required a ventilator longer and had higher rates of infection and kidney failure than those who got fresher blood."

However, for infant heart surgery patients, fresh blood has been found to not be the best option. Rather, reconstituted blood seems to work better for infants. Reconstituted blood, according to Southwestern Medical Center (the group that published the findings), is "...packed red cells and fresh-frozen plasma that are mixed in the operating room just before use."

Both the National Institutes of Health and the Cleveland Clinic are going to perform further studies to find more information to either support or refute the current findings. Tweaking the older stored blood to remove microparticles, which may affect the viability of the older blood, is also being looked in to. By filtering older blood it may be possible to increase its efficacy and reduce potential negative effects.

Is Fresher Blood Better for Surgery?, http://www.msnbc.msn.com/id/38416997/ns/health-health_care

Reconstituted blood is better for infants' heart surgery than fresh blood, http://www.utsouthwestern.edu/utsw/cda/dept37389/files/190995.html

FAQs about Blood and Blood Needs, http://www.givelife2.org/aboutblood/faq.asp#4