Fresh blood no better than old blood in transfusion cases, research concludes

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A new research involving participants from multiple countries has put to rest the growing belief that fresh blood is better than old blood in transfusion cases by concluding that old blood is as good as fresh one and that there is no special advantage of using fresh blood for transfusion.

“Previous observational and laboratory studies have suggested that fresh blood may be better because of the breakdown of red blood cells and accumulation of toxins during storage. But this definitive clinical trial clearly shows that these changes do not affect the quality of blood,” said Dr. Alan Tinmouth, a physician and scientist at the Ottawa Hospital Research Institute and the University of Ottawa.

For the study, researchers undertook the Age of Blood Evaluation (ABLE) study, a randomized double-blind trial to compare mortality after 90 days in intensive care patients transfused with either fresh blood (stored for an average of six days) or older blood (stored for an average of 22 days). A total of 2,430 adults participated in the study from different countries including Canada, Britain, France, the Netherlands and Belgium, including 1,211 patients in the fresh blood group and 1,219 in the older blood group.

The patients who were expected to need transfusions were randomly assigned to get fresh blood — blood that had been stored for less than eight days — or the blood that would normally be sent up from the blood bank.

As per the growing belief that fresh is better, the scientists hypothesized that those who received the fresher blood would do better.

But the results were quite the opposite as researchers found no real differences between the two groups with the number of deaths in the two groups essentially the same. 423 patients died within 90 days post-transfusion in the group of patients who received fresh blood, compared to 398 patients who died in the group that received older blood.

Further, there were no differences between the groups in terms of the length of their hospital stays, the rates of major secondary illnesses they suffered, or other important health measures.

“There was no difference in mortality or organ dysfunction between the two groups, which means that fresh blood is not better than older blood”, said Dr. Dean Fergusson, a senior scientist at the Ottawa Hospital Research Institute and the University of Ottawa.

The findings of the study have been published in the New England Journal of Medicine.