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Table 3 Studies reporting no clinical effect of prolonged RBC storage

From: Age of red blood cells and transfusion in critically ill patients

Author Year Setting N Study design Adjustment for confounders Leukodepletion Outcome and main results
Wasser et al.[47] 1989 Post- CABG 237 Single-center randomized Cases: RBC<12 hours; controls: RBC stored for 2 to 5 days NA No No difference in bleeding and RBC transfusion requirement, nonetheless the platelets counts and thrombotest were significantly less altered in the study arm
Schulman et al.[48] 2002 Trauma, ≥2 RBC units 17 Single-center randomized pilot study “Fresh group”: RBC<11 days; “Old group”: RBC >20 days NA Yes Mortality, infectious complications, respiratory failure
Vamvakas et al.[49] 2000 Post- CABG 268 Retrospective single-center Gender, patient age, comorbidities, type of CABG, IABP, duration of anaesthesia, time on bypass, other surgery, repeated surgery, chest tube drainage volume No Post-operative ICU LOS, hospital LOS and MV duration
Gajic et al.[50] 2004 ICU patients with MV 181 Retrospective single-center APACHE III score, Tidal volume, thrombocytopenia, massive transfusion 70% Median storage duration of the oldest RBC unit = 20.3 days (range: 16–31) in absence of ALI versus 20.1 days (range: 16–27) in presence of ALI
Hebert et al.[51] 2005 ICU 57 Double-blind multicenter, randomized pilot study Comorbidities, major diagnostic grouping, center Yes Composite outcome (mortality, nosocomial infections, thrombotic events, ischemic stroke)
Van de Watering et al.[52] 2006 Post- CABG RBC given during surgery and for 3 days post-surgery 2732 Retrospective single-center study Cases: RBC <18 days Controls: standard cares Year of surgery, volume of transfusion, duration of surgery, previous CABG, number of distal anastomoses, patient age, gender, Hb at admission No 30-day survival, hospital and ICU LOS
Taylor et al.[53] 2006 ICU 449 Prospective single-center observational Patient age, survival probability Mixed Nosocomial infection, mortality, ICU and hospital LOS
Gajic et al.[54] 2007 ICU with ALI 74 Prospective single-center case–control study Patients characteristic, transfusion factors NG Patients with ALI (median of average RBC storage = 22.9 days (range: 17–31) versus 22.9 days (range: 15–30) in controls (p = 0.801)
Yap et al.[55] 2008 Post-CABG and valve surgery, ≥2 RBC units 670 Retrospective single-center Pre-operative risk profile, volume of RBC <5% Mortality, renal failure, nosocomial pneumonia, ICU LOS, MV duration
Van Buskirk et al.[56] 2010 ICU 298 Retrospective single-center Volume of RBC, patient age, gender, severity at ICU admission, admission diagnosis NG Transfusion complications, change in SOFA score, ICU LOS, mortality
Katsios et al.[57] 2011 ICU 126 Prospective single-center observational History of previous DVT, chronic dialysis, platelets transfusion, requirement of vasopressors No DVT
*Mckenny et al.[58] 2011 Post-cardiac surgery 1153 Retrospective single-center Volume of RBC, baseline and patient characteristics Yes Early post-operative mortality, post-operative MV >72h, renal failure, infections, 30 day mortality, hospital mortality, prolonged MV, new renal failure, infectious complications and ICU LOS
Van Straten et al.[59] 2011 Post-CABG, ≤10 RBC units 3475 Retrospective single-center Patient age, comorbidities, redo cardiac surgery, pre-operative Hb, emergency operation, perioperative MI, Re-exploration, year of operation, volume of RBC, FFP and platelets Yes Mortality
Kor et al.[62] 2012 ICU patients with MV 100 Double-blind randomized single-center Cases: one fresh RBC unit (<5 days) Control: one RBC unit of standard practices NA Yes Change in PaO2/FiO2 ratio, in peak and plateau airway pressures, in markers of immune status and in coagulation
  1. NA not applicable; RBC red blood cell; ICU intensive care unit; LOS length of stay; MV mechanical ventilation; DVT deep vein thrombosis; ALI acute lung injury; CABG coronary artery bypass graft, APACHE III score Acute Physiology and Chronic Health Evaluation III score; Hb hemoglobin; MI myocardial infarction; FFP fresh-frozen plasma; SOFA Sequential Organ Failure Assessment; NG not given.
  2. *Blood stored up 35 days and not 42 days.