Acutely ill premature babies who received fresher blood fare no better than those who did not, according to a clinical trial that challenges the widespread notion that fresh blood is better.
“Before now, most of the literature on the subject suggested that fresh red blood cells are better,” says Dean Fergusson, head, Clinical Epidemiology Programme at the Ottawa Hospital Research Institute, who led the study.
“However, the effect of fresher blood on clinical outcomes had never been examined using a randomised clinical trial in human patients, which is considered the gold standard in medical science, Fergusson, also an associate professor at the University of Ottawa, was quoted as saying by the Journal of the American Medical Association.
“Now it has, and we found the standards currently in place are no different for this highly vulnerable population of pre-term infants than a policy and system that would favour fresh blood,” he added, according to an Ottawa statement.
Previous observational studies of patient outcomes used already existing clinical data, which is problematic for a number of key reasons.
Determining the average age of blood and its impact for those transfused more than once is very difficult because the age of red blood cells used in each transfusion could range dramatically within the acceptable shelf life of 42 days.
Called the ARIPI (Age of Red Blood Cells in Premature Infants) Randomized Trial, this study involved 377 babies weighing less than 1,250 grams and requiring red blood cell transfusions.
Randomly, they either received blood that had been stored a week or less, or received the current standard of practice used by blood banks. It turned out that there was no difference in outcome between the two groups.
“Over the years, the number of retrospective studies showing possible harm from older blood has created pressure to change the management of the blood supply to provide fresher transfusion products,” said Dana Devine, vice president, Medical, Scientific and Research Affairs of Canadian Blood Services.
“This is a huge undertaking that would require many more donations than we currently have and greatly increase the cost of operating the blood system,” added Devine.