Stored blood for transfusion becomes less safe with aging, finds new study

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Stored blood can cause complications, finds new study
New research shows current methods of storing blood may be unsafe. Findings from scientists at Wake Forest University and the University of Pittsburgh School of Medicine found some complications associated with blood transfusion comes from the breakdown of red blood cells that happens during storage.

The finding means it may be necessary to find new ways to preserve blood for transfusion.

According to background information from the study, someone in the United States needs a blood transfusion every two seconds.

The finding, published in the journal  Circulation, found nitric oxide (NO) interacts with stored red blood cells, breaking down blood flow. For transfusion recipients, vital tissues can be damaged from blood stored for long periods of time.

Higher rates of infection risk, kidney, lung or multi-organ failure and death have been observed among patients given transfusions from blood stored for longer periods of time, leading the researchers to try to understand why.

Stored blood can restrict blood flow, leading to organ damage
Mark T. Gladwin, M.D., chief, Division of Pulmonary, Allergy and Critical Care Medicine, Pitt School of Medicine, and director of Pitt’s Vascular Medicine Institute explains:

“When blood sits for a while, some of the cells break down and release their contents, which include molecules of hemoglobin and red blood cell microparticles. These accumulate in the stored bag of blood and are transfused into the patient with the blood. In the bloodstream, the hemoglobin and microparticles bind to and destroy NO, a very important molecule that is used by the body to keep blood vessels dilated for normal blood flow.”

NO in stored blood then constricts blood flow, depriving organs of oxygen and promoting inflammation, Gladwin explains.

Daniel B. Kim–Shapiro, Ph.D., professor of physics and director of the Translational Science Center at Wake Forest said, 

“Transfusion of stored blood is one of the most common medical therapies. By understanding the mechanism of the storage lesion, we can design methods to make blood transfusion safer. For example, perhaps we can restore nitric oxide activity that is lost upon transfusion, use preservation solutions that better limit the degradation of blood cells, or develop agents that scavenge free hemoglobin.”

According to current guidelines, blood can be stored up to 42 days for transfusion. The new finding suggests blood stored for transfusion may not be safe, leading to complications if inflammation and impaired oxygen to organs. 


Impaired adenosine-5′-triphosphate release from red blood cells promotes their adhesion to endothelial cells: A mechanism of hypoxemia after transfusion.; Hongmei Zhu, Rahima Zennadi, Bruce X. Xu, Jerry P. Eu, Jordan A. Torok, Marilyn J. Telen, Timothy J. McMahon.; Critical Care Medicine, 2011; DOI: 10.1097/CCM.0b013e318225754f

Duke researchers also warned of the dangers to patients from storing blood in 2007 in this video.