Avoiding the hazard of old blood

If you’re facing surgery, you may not realize that the donated blood hospitals use for transfusions has the equivalent of the “sell by” date on a carton of milk. Blood can be stored for only six weeks. But supplies stored for more than two weeks may pose problems for certain patients undergoing heart surgery, according to a study from the famed Cleveland Clinic. Patients who received older blood were more likely to develop such complications as kidney failure or sepsis (a blood disorder) or to require breathing help from a ventilator for more than three days, and, worst of all, to die within a year.

The problem is that red blood cells deteriorate after two to three weeks of storage, says study leader Colleen G. Koch, MD. Since donated blood tends to be in short supply anyway, the notion of dumping older blood and just using the freshest isn’t practical; there wouldn’t be nearly enough for the 14 million units of blood transfused in the United States every year. Besides, more research is needed to see whether these results hold up.

What should patients do?
Your best bet is to do what you can to reduce your need for a transfusion. Ask about your surgeon’s transfusion rate with similar surgery. (It should be no more than 50%, says James AuBuchon, MD, a blood-banking specialist at Dartmouth Medical School in Lebanon, N.H.) Routine presurgical testing includes blood work, which can show whether you’re anemic. If you are, Dr. Koch advises talking to your doctor about how to increase your hemoglobin (a protein that carries oxygen in the blood). “If you’re not anemic, you may be a candidate for autotransfusion, a procedure in which you donate your own blood before your surgery.”