Coagulation Properties of Fresh Blood Lasts Longer Than Assumed

The blood clotting properties of refrigerated whole blood may have a shelf life well beyond the current standard of 24 to 48 hours.

The majority of patients receiving blood transfusions only require specific components of whole blood, such as red blood cells, plasma and platelets and the coagulation properties are thought to decline rapidly.

A study carried out at The Children's Hospital of Philadelphia, (Philadelphia, PA, USA), examined the freshness of whole blood with respect to its clotting properties in 21 units of blood from healthy volunteer donors. The units of blood were stored under standard conditions as mandated by the American Association of Blood Banks, (AABB; Bethesda, MD, USA). Samples were obtained on the day after donation and again on days 2, 4, 7, 11, 14, 17, 21, 24, and 31. Tests included complete blood count, pH, partial pressures of oxygen and carbon dioxide (pO2, pCO2), glucose, lactate, thromboelastography (TEG), and platelet function by light transmission aggregometry (LTA).

The current practice at The Children's Hospital of Philadelphia assumes a fresh whole blood shelf life of 48 hours when refrigerated. After that point, the erythrocytes may be recovered from the whole blood, but the other components, such as plasma and platelets must be discarded. However, the scientists found that TEG and platelet aggregation levels, which measure the efficiency of blood coagulation, remain normal at least 11 days under standard refrigerated conditions.

David Jobes, MD, a cardiothoracic anesthesiologist at the hospital, said, "Trauma patients could potentially benefit, as well as others needing a large volume of blood replacement, such as patients undergoing liver transplant or children who need craniofacial reconstruction. The results of the study strongly suggest that clinical trials should proceed to test the value of whole blood beyond a 48-hour period." The study was published in January 2011, in the journal Transfusion.

Related Links:

The Children's Hospital of Philadelphia

American Association of Blood Banks