title: Storage time of transfused red blood cells and impact on clinical outcomes in hematopoietic stem cell transplantation.
abstract: BACKGROUND
  Red blood cell (RBC) transfusion may prolong recovery in some patients, perhaps due to changes that occur during more prolonged RBC storage. We examined the impact of RBC transfusion and the age of transfused RBC units on clinical outcomes in hematopoietic stem cell transplantation (HSCT).
  
  
  METHODS
  Data concerning RBC transfusions between Day 0 and Day +30 were analyzed for patients undergoing HSCT (n = 555) at a single institution. "Old" RBC units were defined as those stored for 15 days or longer.
  
  
  RESULTS
  The proportion of old RBC units transfused and the mean age of transfused units did not correlate with 100-day nonrelapse mortality, organ-specific toxicity, length of stay (LOS), or incidence of intensive care unit (ICU) admission (p > 0.05). In comparing the 71 patients who received only old RBC units with 218 patients who received only "new" RBC units, there was no increase in adverse clinical outcomes after HSCT. Autologous transplant recipients (n = 355, 3.8 units/patient) were more likely to avoid RBC transfusion and received fewer units compared with allogeneic recipients (n = 200, 6.4 units/patient, p < 0.0001). The mean number of transfused RBC units was greater in patients admitted to the ICU (10.5 units vs. 3.7 units/patient, p < 0.01), correlated with longer LOS (p < 0.0001), and correlated with increasing number of organ systems with toxicity of at least Grade 2 (p < 0.0001).
  
  
  CONCLUSIONS
  The importance of RBC storage time does not appear to influence clinical outcomes in HSCT. Patients with increased RBC transfusion requirements have greater toxicity after HSCT. Whether RBC transfusion contributes to toxicity, however, remains unclear.
authors.affiliation: Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Natasha
authors.initials: N
authors.lastname: Kekre
authors.forename: Andrew
authors.initials: A
authors.lastname: Chou
authors.forename: Melanie
authors.initials: M
authors.lastname: Tokessey
authors.forename: Steve
authors.initials: S
authors.lastname: Doucette
authors.forename: Alan
authors.initials: A
authors.lastname: Tinmouth
authors.forename: Jason
authors.initials: J
authors.lastname: Tay
authors.forename: David S
authors.initials: DS
authors.lastname: Allan
mesh_terms: D000328:Adult; D000368:Aged; D001793:Blood Preservation; D017707:Erythrocyte Transfusion; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D013997:Time Factors