title: Fresh blood for transfusion in adults with beta thalassaemia.
abstract: BACKGROUND
  Patients with beta-thalassaemia major require life-long blood transfusion with the aim of achieving normal growth and development whilst minimising iron overload. A pre-transfusion Hb between 9.5 and 10 g/dL is thought to achieve this balance. UK consensus is that fresh blood (less than 14 days) is better at maintaining this target pre-transfusion Hb but there is no firm stipulation in place and no robust evidence supporting this.
  
  
  METHODS
  After introduction of a universal fresh blood policy for adult beta-thalassaemics in 2010, we reviewed locally transfused adult patients to determine if there was any significant difference in pre-transfusion Hb using fresh blood. Nine adult thalassaemic patients were analysed for two consecutive 6-month periods in 2009 and 2010 (periods 1 and 2).
  
  
  RESULTS
  Mean pre-transfusion Hb was significantly higher by an average of 0.5 g/dL in period 2 than period 1 (P < 0.05). The average unit age was 18 vs 9.5 days for periods 1 and 2 respectively (P < 0.05). There were no significant differences in potential confounders such as transfusion volume (P = 0.06), number of units transfused, ferritin or transfusion interval.
  
  
  CONCLUSIONS
  Use of fresh blood produced significantly higher pre-transfusion Hb, giving credence to UK consensus. Lesser volumes of fresh blood appeared to achieve the target pre-transfusion Hb, which may translate to reduced iron overload and chelation costs. Whether the assumption that the use of blood less than 7 days old in these patients would result in greater benefit requires further study.
authors: Department of Clinical Haematology, Manchester Royal Infirmary NHS Blood and Transplant Service, Manchester, UK. npriddee@doctors.org.uk
authors: N R
authors: NR
authors: Priddee
authors: K
authors: K
authors: Pendry
authors: K E
authors: KE
authors: Ryan
mesh_terms: D000328:Adult; D001803:Blood Transfusion / Q000592:standards*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D019190:Iron Overload; D008297:Male; D017410:Practice Guidelines as Topic; D013997:Time Factors; D006113:United Kingdom; D055815:Young Adult; D017086:beta-Thalassemia / Q000628:therapy*
chemical_list: D006454:Hemoglobins