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Factors affecting red blood cell storage age at the time of transfusion

Authors

  • Walter H. Dzik,

    Corresponding author
    1. Massachusetts General Hospital, Boston, Massachusetts
    2. Filton Blood Centre, Bristol, UK
    3. John Radcliffe Hospital, National Blood Service, Oxford, UK
    4. University of Washington, Seattle, Washington
    5. New Zealand Blood Service, Auckland, New Zealand
    6. Fletcher Allen Health Care, Burlington, Vermont
    7. Hema Quebec, Ste-Foy, Quebec, Canada
    8. Beth Israel Deaconess Medical Center, Boston, Massachusetts
    9. Hospital Clinic Provincial, Barcelona, Spain
    10. Hoxworth Blood Center, Cincinnati, Ohio
    11. Sírio Libanês Hospital, São Paulo, Brazil
    12. Dartmouth-Hitchcock Medical Center, Lebanon, NH
    • Address correspondence to: Walter H. Dzik, Blood Transfusion Service, Massachusetts General Hospital, Room J-224, 55 Fruit Street, Boston, MA 02114; e-mail: sdzik@partners.org.

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  • Neil Beckman,

    1. Massachusetts General Hospital, Boston, Massachusetts
    2. Filton Blood Centre, Bristol, UK
    3. John Radcliffe Hospital, National Blood Service, Oxford, UK
    4. University of Washington, Seattle, Washington
    5. New Zealand Blood Service, Auckland, New Zealand
    6. Fletcher Allen Health Care, Burlington, Vermont
    7. Hema Quebec, Ste-Foy, Quebec, Canada
    8. Beth Israel Deaconess Medical Center, Boston, Massachusetts
    9. Hospital Clinic Provincial, Barcelona, Spain
    10. Hoxworth Blood Center, Cincinnati, Ohio
    11. Sírio Libanês Hospital, São Paulo, Brazil
    12. Dartmouth-Hitchcock Medical Center, Lebanon, NH
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  • Michael F. Murphy,

    1. Massachusetts General Hospital, Boston, Massachusetts
    2. Filton Blood Centre, Bristol, UK
    3. John Radcliffe Hospital, National Blood Service, Oxford, UK
    4. University of Washington, Seattle, Washington
    5. New Zealand Blood Service, Auckland, New Zealand
    6. Fletcher Allen Health Care, Burlington, Vermont
    7. Hema Quebec, Ste-Foy, Quebec, Canada
    8. Beth Israel Deaconess Medical Center, Boston, Massachusetts
    9. Hospital Clinic Provincial, Barcelona, Spain
    10. Hoxworth Blood Center, Cincinnati, Ohio
    11. Sírio Libanês Hospital, São Paulo, Brazil
    12. Dartmouth-Hitchcock Medical Center, Lebanon, NH
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  • Meghan Delaney,

    1. Massachusetts General Hospital, Boston, Massachusetts
    2. Filton Blood Centre, Bristol, UK
    3. John Radcliffe Hospital, National Blood Service, Oxford, UK
    4. University of Washington, Seattle, Washington
    5. New Zealand Blood Service, Auckland, New Zealand
    6. Fletcher Allen Health Care, Burlington, Vermont
    7. Hema Quebec, Ste-Foy, Quebec, Canada
    8. Beth Israel Deaconess Medical Center, Boston, Massachusetts
    9. Hospital Clinic Provincial, Barcelona, Spain
    10. Hoxworth Blood Center, Cincinnati, Ohio
    11. Sírio Libanês Hospital, São Paulo, Brazil
    12. Dartmouth-Hitchcock Medical Center, Lebanon, NH
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  • Peter Flanagan,

    1. Massachusetts General Hospital, Boston, Massachusetts
    2. Filton Blood Centre, Bristol, UK
    3. John Radcliffe Hospital, National Blood Service, Oxford, UK
    4. University of Washington, Seattle, Washington
    5. New Zealand Blood Service, Auckland, New Zealand
    6. Fletcher Allen Health Care, Burlington, Vermont
    7. Hema Quebec, Ste-Foy, Quebec, Canada
    8. Beth Israel Deaconess Medical Center, Boston, Massachusetts
    9. Hospital Clinic Provincial, Barcelona, Spain
    10. Hoxworth Blood Center, Cincinnati, Ohio
    11. Sírio Libanês Hospital, São Paulo, Brazil
    12. Dartmouth-Hitchcock Medical Center, Lebanon, NH
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  • Mark Fung,

    1. Massachusetts General Hospital, Boston, Massachusetts
    2. Filton Blood Centre, Bristol, UK
    3. John Radcliffe Hospital, National Blood Service, Oxford, UK
    4. University of Washington, Seattle, Washington
    5. New Zealand Blood Service, Auckland, New Zealand
    6. Fletcher Allen Health Care, Burlington, Vermont
    7. Hema Quebec, Ste-Foy, Quebec, Canada
    8. Beth Israel Deaconess Medical Center, Boston, Massachusetts
    9. Hospital Clinic Provincial, Barcelona, Spain
    10. Hoxworth Blood Center, Cincinnati, Ohio
    11. Sírio Libanês Hospital, São Paulo, Brazil
    12. Dartmouth-Hitchcock Medical Center, Lebanon, NH
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  • Marc Germain,

    1. Massachusetts General Hospital, Boston, Massachusetts
    2. Filton Blood Centre, Bristol, UK
    3. John Radcliffe Hospital, National Blood Service, Oxford, UK
    4. University of Washington, Seattle, Washington
    5. New Zealand Blood Service, Auckland, New Zealand
    6. Fletcher Allen Health Care, Burlington, Vermont
    7. Hema Quebec, Ste-Foy, Quebec, Canada
    8. Beth Israel Deaconess Medical Center, Boston, Massachusetts
    9. Hospital Clinic Provincial, Barcelona, Spain
    10. Hoxworth Blood Center, Cincinnati, Ohio
    11. Sírio Libanês Hospital, São Paulo, Brazil
    12. Dartmouth-Hitchcock Medical Center, Lebanon, NH
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  • Richard L. Haspel,

    1. Massachusetts General Hospital, Boston, Massachusetts
    2. Filton Blood Centre, Bristol, UK
    3. John Radcliffe Hospital, National Blood Service, Oxford, UK
    4. University of Washington, Seattle, Washington
    5. New Zealand Blood Service, Auckland, New Zealand
    6. Fletcher Allen Health Care, Burlington, Vermont
    7. Hema Quebec, Ste-Foy, Quebec, Canada
    8. Beth Israel Deaconess Medical Center, Boston, Massachusetts
    9. Hospital Clinic Provincial, Barcelona, Spain
    10. Hoxworth Blood Center, Cincinnati, Ohio
    11. Sírio Libanês Hospital, São Paulo, Brazil
    12. Dartmouth-Hitchcock Medical Center, Lebanon, NH
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  • Miguel Lozano,

    1. Massachusetts General Hospital, Boston, Massachusetts
    2. Filton Blood Centre, Bristol, UK
    3. John Radcliffe Hospital, National Blood Service, Oxford, UK
    4. University of Washington, Seattle, Washington
    5. New Zealand Blood Service, Auckland, New Zealand
    6. Fletcher Allen Health Care, Burlington, Vermont
    7. Hema Quebec, Ste-Foy, Quebec, Canada
    8. Beth Israel Deaconess Medical Center, Boston, Massachusetts
    9. Hospital Clinic Provincial, Barcelona, Spain
    10. Hoxworth Blood Center, Cincinnati, Ohio
    11. Sírio Libanês Hospital, São Paulo, Brazil
    12. Dartmouth-Hitchcock Medical Center, Lebanon, NH
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  • Ronald Sacher,

    1. Massachusetts General Hospital, Boston, Massachusetts
    2. Filton Blood Centre, Bristol, UK
    3. John Radcliffe Hospital, National Blood Service, Oxford, UK
    4. University of Washington, Seattle, Washington
    5. New Zealand Blood Service, Auckland, New Zealand
    6. Fletcher Allen Health Care, Burlington, Vermont
    7. Hema Quebec, Ste-Foy, Quebec, Canada
    8. Beth Israel Deaconess Medical Center, Boston, Massachusetts
    9. Hospital Clinic Provincial, Barcelona, Spain
    10. Hoxworth Blood Center, Cincinnati, Ohio
    11. Sírio Libanês Hospital, São Paulo, Brazil
    12. Dartmouth-Hitchcock Medical Center, Lebanon, NH
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  • Zbigniew Szczepiorkowski,

    1. Massachusetts General Hospital, Boston, Massachusetts
    2. Filton Blood Centre, Bristol, UK
    3. John Radcliffe Hospital, National Blood Service, Oxford, UK
    4. University of Washington, Seattle, Washington
    5. New Zealand Blood Service, Auckland, New Zealand
    6. Fletcher Allen Health Care, Burlington, Vermont
    7. Hema Quebec, Ste-Foy, Quebec, Canada
    8. Beth Israel Deaconess Medical Center, Boston, Massachusetts
    9. Hospital Clinic Provincial, Barcelona, Spain
    10. Hoxworth Blood Center, Cincinnati, Ohio
    11. Sírio Libanês Hospital, São Paulo, Brazil
    12. Dartmouth-Hitchcock Medical Center, Lebanon, NH
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  • Silvano Wendel

    1. Massachusetts General Hospital, Boston, Massachusetts
    2. Filton Blood Centre, Bristol, UK
    3. John Radcliffe Hospital, National Blood Service, Oxford, UK
    4. University of Washington, Seattle, Washington
    5. New Zealand Blood Service, Auckland, New Zealand
    6. Fletcher Allen Health Care, Burlington, Vermont
    7. Hema Quebec, Ste-Foy, Quebec, Canada
    8. Beth Israel Deaconess Medical Center, Boston, Massachusetts
    9. Hospital Clinic Provincial, Barcelona, Spain
    10. Hoxworth Blood Center, Cincinnati, Ohio
    11. Sírio Libanês Hospital, São Paulo, Brazil
    12. Dartmouth-Hitchcock Medical Center, Lebanon, NH
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  • [Correction added after online publication 03-Apr-2013: Affiliations have been updated.]
  • From the Biomedical Excellence for Safer Transfusion Collaborative: http://www.bestcollaborative.org/.

Abstract

Background

Clinical trials are investigating the potential benefit resulting from a reduced maximum storage interval for red blood cells (RBCs). The key drivers that determine RBC age at the time of issue vary among individual hospitals. Although progressive reduction in the maximum storage period of RBCs would be expected to result in smaller hospital inventories and reduced blood availability, the magnitude of the effect is unknown.

Study Design and Methods

Data on current hospital blood inventories were collected from 11 hospitals and three blood centers in five nations. A general predictive model for the age of RBCs at the time of issue was developed based on considerations of demand for RBCs in the hospital.

Results

Age of RBCs at issue is sensitive to the following factors: ABO group, storage age at the time of receipt by the hospital, the restock interval, inventory reserve, mean demand, and variation in demand.

Conclusions

A simple model, based on hospital demand, may serve as the basis for examining factors affecting the storage age of RBCs in hospital inventories. The model suggests that the age of RBCs at the time of their issue to the patient depends on factors external to the hospital transfusion service. Any substantial change in the expiration date of stored RBCs will need to address the broad variation in demand for RBCs while attempting to balance considerations of availability and blood wastage.

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