title: Transfusion of cryopreserved packed red blood cells is safe and effective after trauma: a prospective randomized trial.
abstract: OBJECTIVE
  To determine the safety and efficacy of cryopreserved packed red blood cell (CPRBC) transfusion in trauma patients.
  
  
  BACKGROUND
  Liquid packed red blood cells (LPRBCs) have an abbreviated shelf-life and worsening storage lesion with age. CPRBCs are frozen 2 to 6 days after donation, stored up to 10 years, and are available for 14 days after thawing and washing. CPRBCs can be utilized in diverse settings, but the effect on clinical outcomes is unknown.
  
  
  METHODS
  We performed a prospective, randomized, double-blind study at 5 level 1 trauma centers. Stable trauma patients requiring transfusion were randomized to young LPRBCs (≤14 storage days), old LPRBCs (>14 storage days), or CPRBCs. Tissue oxygenation (StO2), biochemical and inflammatory mediators were measured, and clinical outcomes were determined.
  
  
  RESULTS
  Two hundred fifty-six patients with well-matched injury severity and demographics (P > 0.2) were randomized (84 young, 86 old, and 86 CPRBCs). Pretransfusion and final hematocrits were similar (P > 0.68). Patients in all groups received the same number of units postrandomization (2 [1-4]; P > 0.05). There was no difference in the change in tissue oxygenation between groups. CPRBCs contained less α2-macrogobulin, haptoglobin, C-reactive protein, and serum amyloid P (P < 0.001). Organ failure, infection rate, and mortality did not differ between groups (P > 0.2).
  
  
  CONCLUSIONS
  Transfusion of CPRBCs is as safe and effective as transfusion of young and old LPRBCs and provides a mechanism to deliver PRBCs in a wide variety of settings.
authors.affiliation: *Department of Surgery, Oregon Health & Science University, Portland, OR †Department of Surgery, University of Texas at Houston, Houston, TX ‡Department of Surgery, University of Cincinnati, Cincinnati, OH §Department of Surgery UT Southwestern/Parkland Memorial Hospital, Dallas, TX; and ¶Department of Surgery, University of Texas San Antonio, San Antonio, TX.
authors.forename: Martin A
authors.initials: MA
authors.lastname: Schreiber
authors.forename: Belinda H
authors.initials: BH
authors.lastname: McCully
authors.forename: John B
authors.initials: JB
authors.lastname: Holcomb
authors.forename: Bryce R
authors.initials: BR
authors.lastname: Robinson
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Minei
authors.forename: Ronald
authors.initials: R
authors.lastname: Stewart
authors.forename: Laszlo
authors.initials: L
authors.lastname: Kiraly
authors.forename: Nicole T
authors.initials: NT
authors.lastname: Gordon
authors.forename: David T
authors.initials: DT
authors.lastname: Martin
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Rick
authors.forename: Rondi K
authors.initials: RK
authors.lastname: Dean
authors.forename: Connor
authors.initials: C
authors.lastname: Wiles
authors.forename: Nathan
authors.initials: N
authors.lastname: Anderson
authors.forename: Dennis
authors.initials: D
authors.lastname: Sosnovske
authors.forename: Ben
authors.initials: B
authors.lastname: Houser
authors.forename: Diane
authors.initials: D
authors.lastname: Lape
authors.forename: Bryan
authors.initials: B
authors.lastname: Cotton
authors.forename: Dina
authors.initials: D
authors.lastname: Gomaa
authors.forename: Michael W
authors.initials: MW
authors.lastname: Cripps
authors.forename: Mark
authors.initials: M
authors.lastname: DeRosa
authors.forename: Samantha J
authors.initials: SJ
authors.lastname: Underwood
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D001771:Blood Banks; D001793:Blood Preservation / Q000379:methods*; D058731:Blood Safety; D003131:Combined Modality Therapy; D015925:Cryopreservation / Q000379:methods*; D004311:Double-Blind Method; D017707:Erythrocyte Transfusion / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D015996:Survival Rate; D013997:Time Factors; D014193:Trauma Centers; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*