The effect of fresh versus standard blood transfusion on microvascular endothelial function.
BACKGROUND
The duration of red blood cell (RBC) storage may have a negative impact on endothelial nitric oxide bioavailability. We tested the hypothesis that transfused fresh blood will have a more favorable effect on microvascular endothelial function as compared to older standard issue blood.


METHODS
Participants requiring chronic RBC transfusions were enrolled in a crossover design study to receive fresh (<7 days of storage) or standard (up to 42 days of storage) blood on 2 separate visits. Endothelial function was assessed by reactive hyperemia peripheral arterial tonometry that was measured before and after transfusions. For each participant, the difference between endothelial function pretransfusion and posttransfusion was assessed in relation to blood storage time.


RESULTS
Twenty-one patients (71 ± 16 years, 52% females) were enrolled. Mean age of fresh blood was 5.5 days (±1.0), and that of standard blood was 24.5 days (±7.9 days). The pretransfusion hemoglobin was 83.1 ± 2.5 g/L; and posttransfusion, 98.9 ± 2.6 g/L. An average of 2 U of packed RBCs was transfused. Microvascular endothelial function decreased more frequently after transfusion of standard blood compared to fresh blood. Standard issue blood transfusion was associated with decrease in reactive hyperemia peripheral arterial tonometry index (-0.25 ± 0.63) compared to fresh blood (+0.03 ± 0.49); P = .026.


CONCLUSIONS
Transfusions of standard issue blood are associated with less favorable effect on microvascular endothelial function as compared to fresh blood.
Division of Cardiology, London Health Sciences Centre, Western University, London, Ontario, Canada.
Yasir
Y
Parviz
Division of Hematology, London Health Sciences Centre, Western University, London, Ontario, Canada.
Cyrus
C
Hsia
Division of Cardiology, London Health Sciences Centre, Western University, London, Ontario, Canada.
Mistre
M
Alemayehu
Division of Cardiology, London Health Sciences Centre, Western University, London, Ontario, Canada.
Sabrina
S
Wall
Division of Cardiology, London Health Sciences Centre, Western University, London, Ontario, Canada.
Rodrigo
R
Bagur
Division of Cardiology, London Health Sciences Centre, Western University, London, Ontario, Canada.
Nour
N
AbuRomeh
Division of Hematology, London Health Sciences Centre, Western University, London, Ontario, Canada.
Ian
I
Chin-Yee
Division of Cardiology, London Health Sciences Centre, Western University, London, Ontario, Canada. Electronic address: shahar.lavi@lhsc.on.ca.
Shahar
S
Lavi
D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000628:therapy; D000094902:Blood Banking / Q000379:methods*; D001803:Blood Transfusion / Q000379:methods; D018592:Cross-Over Studies; D004730:Endothelium, Vascular / Q000503:physiopathology*; D017707:Erythrocyte Transfusion / Q000379:methods*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology*; D008232:Lymphoproliferative Disorders / Q000628:therapy; D008297:Male; D008365:Manometry; D055806:Microvessels / Q000503:physiopathology*; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000628:therapy; D011446:Prospective Studies; D013997:Time Factors