title: The effect of red blood cell age on coagulation.
abstract: BACKGROUND
  Packed red blood cell (PRBC) units stored and unused at community hospitals are transferred to trauma centers near the end of their shelf storage life, because of a higher likelihood of utilization before expiration without consideration of coagulation system effects. This study was conducted to determine if the stored age of PRBC units has an effect on coagulation.
  
  
  METHODS
  Single-donor citrate/phosphate/dextrose-preserved, PRBCs, and fresh frozen plasma (FFP) were recalcified in an in vitro model. The activated clotting time (ACT) was measured using the microsample method on days 3, 19, 20, and 33 from the date of donation.
  
  
  RESULTS
  The ACT was prolonged as the age of PRBCs increased while other factors were held constant. ACTs on days 19, 20, and 33 were prolonged relative to day 3. Measurements taken on day 33 were significantly prolonged relative to day 20.
  
  
  CONCLUSIONS
  Increasing age of PRBCs measured from the date of donation adversely affects the global coagulation status. This study suggests that we should re-evaluate current blood banking and transfusion practices in trauma care.
authors.affiliation: University of Illinois Urbana-Champaign/Carle Foundation Hospital, Urbana, IL, USA. john.aucar@carle.com
authors.forename: John A
authors.initials: JA
authors.lastname: Aucar
authors.forename: Edan
authors.initials: E
authors.lastname: Isaak
authors.forename: Douglas
authors.initials: D
authors.lastname: Anthony
mesh_terms: D001777:Blood Coagulation; D001793:Blood Preservation / Q000592:standards* / Q000706:statistics & numerical data*; D004912:Erythrocytes; D006801:Humans; D013997:Time Factors