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• W2038867650 endingPage "107" @default.
• W2038867650 startingPage "91" @default.
• W2038867650 abstract "W E ARE NOW ENTERING the second century in which human blood has been stored for transfusion. In the last 2 decades of the last century, we witnessed a dramatic shift ''1 in which a product once regarded as one of the great advances in modern medicine ''2 was now viewed as potentially harmful. Precipitated by the identification of transfusion-transmitted infections, this paradigm shift has led to a reexamination of the quality of stored blood for transfusion. In this context, contaminating leukocytes, which were an accepted part of red blood cell (RBC) transfusion, have now been implicated in alloimmunization, graft-versus-host disease, cytomegalovirus transmission, and immunomodulation. 3 Another recognized biologic phenomena associated with RBC storage includes the induction of the storage lesion, which can be defined as a series of biochemical and biomechanical changes in the red cell occurring during preservation that reduces subsequent in vivo survival and function. Our understanding of the mechanisms involved in these changes is incomplete, but recent clinical trials and animal experiments have raised fundamental questions about the putative efficacy of stored blood. A large randomized trial comparing a liberal with a conservative transfusion strategy in the critically ill yielded the surprising result that lowering the hemoglobin threshold for RBC transfusions is not only safe but may be associated with reduced mortality. 4 Two studies have suggested that morbidity or mortality may increase with the duration of RBC storage before transfusion. 5,6 In light of these recent findings, we reexamine storage-related changes in RBC shape in relation to posttransfusion survival and RBC function. The experimental data from animal models will be discussed along with recent clinical trials in transfusion medicine, speculating on a possible association between storage-related changes and adverse clinical consequences of transfusing blood." @default.
• W2038867650 created "2016-06-24" @default.
• W2038867650 creator A5077778585 @default.
• W2038867650 creator A5082823626 @default.
• W2038867650 date "2001-04-01" @default.
• W2038867650 modified "2023-10-14" @default.
• W2038867650 title "The clinical consequences of the red cell storage lesion" @default.
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