New blood, old blood, or no blood?

The use of blood transfusions in medicine is so well established that the procedure is an afterthought to many physicians. Scientific advances have rendered blood and blood products extremely safe through the introduction of donor-deferral strategies, infectious-disease testing, pathogen-inactivation methods, and recombinant DNA technologies for particular therapeutic proteins. These advances have dramatically reduced the likelihood of transfusion-transmitted disease so that the risk of transfusion-associated human immunodeficiency virus 1 or hepatitis C infection, for example, is now on the order of 1 in 2 million donated units.1 Concern persists about the transmission of other infectious agents, for which testing is not . . .

[1]  T. Mihaljevic,et al.  Duration of red-cell storage and complications after cardiac surgery. , 2008, The New England journal of medicine.

[2]  E. Vamvakas,et al.  Transfusion-related immunomodulation (TRIM): an update. , 2007, Blood reviews.

[3]  Robert M Califf,et al.  Evolution of adverse changes in stored RBCs , 2007, Proceedings of the National Academy of Sciences.

[4]  D. Fergusson,et al.  Clinical consequences of red cell storage in the critically ill , 2006, Transfusion.

[5]  A. Brand,et al.  Effects of storage time of red blood cell transfusions on the prognosis of coronary artery bypass graft patients , 2006, Transfusion.

[6]  E. Vamvakas,et al.  The continuing risk of transfusion-transmitted infections. , 2006, New England Journal of Medicine.

[7]  C. Silliman,et al.  Transfusion-related acute lung injury. , 2005, Blood.

[8]  Sally Caglioti,et al.  Detection of HIV-1 and HCV infections among antibody-negative blood donors by nucleic acid-amplification testing. , 2004, The New England journal of medicine.

[9]  W. Sibbald,et al.  Effects of storage on efficacy of red cell transfusion: When is it not safe? , 2003, Critical care medicine.

[10]  S. Leal-Noval,et al.  Influence of Erythrocyte Concentrate Storage Time on Postsurgical Morbidity in Cardiac Surgery Patients , 2003, Anesthesiology.

[11]  E. Vamvakas,et al.  Length of storage of transfused red cells and postoperative morbidity in patients undergoing coronary artery bypassgraft surgery , 2000, Transfusion.

[12]  G. Wells,et al.  A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group. , 1999, The New England journal of medicine.