Efficacy and Safety of Frozen Blood for Transfusion in Trauma Patients - A Multi-Center Trial
Abstract
An abbreviated shelf life and storage lesion limit the utility of standard red blood cells (RBCs). Cryopreserved red blood cells (CPRBCs) are frozen from 2-6 days after donation, stored up to 10 years, and washed and deglycerolized prior to use, potentially providing a versatile, fresh, and pure RBC product. We hypothesized that CPRBC transfusion would be equivalent to RBC transfusion in stable trauma patients. We performed a prospective, randomized, double blind study at five level 1 trauma centers. Stable trauma patients requiring transfusion were randomized to old RBCs (greater than 14 storage days), young RBCs (less than 14 storage days), or CPRBCs. Tissue oxygenation and biochemical and inflammatory parameters were measured and clinical outcomes were determined. In total, 256 patients were randomized (84 young, 86 old, and 86 CPRBCs). The patients were well matched for injury severity and demographics (p greater than 0.2). Pre-transfusion and final hematocrits were similar (p>0.68). Patients randomized to CPRBCs required two units, compared to four units of RBCs in the other groups (p<0.001). Transfusion of old RBCs resulted in reduced tissue oxygenation, while transfusion of CPRBCs resulted in an increase (p less than0.05). CPRBCs contained significantly less a2-macrogobulin, haptoglobin, c-reactive protein, serum amyloid P, and free hemoglobin than the other groups (p less than 0.001). Interleukin-2 was elevated in patients who received CPRBCs compared to old RBCs. There was no difference in organ failure, infection rate, or mortality between the three groups (p>0.22). Transfusion of CPRBCs is at least as safe and effective as transfusion of RBCs and results in a reduced transfusion requirement.
Document Details
- Document Type
- Technical Report
- Publication Date
- Apr 01, 2015
- Accession Number
- ADA617679
Entities
People
- Belinda H. Mccully
- Laszlo N. Kiraly
- Martin A. Schreiber
- Samantha J. Underwood
Organizations
- Oregon Health & Science University