Hunter research warns of transfusion dangers (Daily Telegraph 24/11/2010)
Deadline in blood
HUNDREDS of Australians are dying in hospitals each year because they have been given transfusions of stale blood, Hunter researchers have found.
A 10-year Hunter New England Health study of more than 20,000 blood transfusions has found patients who get blood more than 14 days old are up to four times more likely to develop potentially lethal blood poisoning.
The study, the largest of its kind in the world, is expected to have a major impact on the way blood donations and transfusions are handled.
Researchers have recommended an immediate ban on all blood products older than 35 days to NSW Chief Health Officer Kerry Chant, who is expected to take the issue to the National Blood Authority.
Under current world health guidelines, blood donations can be stored for up to 42 days. .
Hunter New England Health has instituted its own embargo on blood older than 35 days and is trying to get that down to 28 days.
The research will be presented to the American Society of Haematology in Florida on December 6.
An estimated 6000 people in the Hunter New England area have blood transfusions each year.
Researchers have emphasised their findings should not be a reason for people to stop donating blood, but an encouragement to do so more regularly.
The older blood is not infected but rather, because blood starts to break down over time older blood weakens the immune system and makes. patients more vulnerable to hospital infections.
Lead author Dr Stephen O'Mara said patients should not refuse blood transfusions but rather question their age and whether they really need one.
"Blood transfusion is an essential part of medical care," he said.
"Fresh blood less than 14 days of age is completely safe."
Dr O'Mara said the use of old blood was a bigger blood safety issue than HIV/AIDS or mad cow disease.
The findings meant surgeons would need to be more frugal with transfusions after surgery.
In the 1990's a new preservative increased the storage age of blood to 42 days but it is only in the last three years researchers have started to question its use.
"There was no safety data published to determine if this older blood was safe," Dr O'Mara said.
"If this was a new drug it would never have been 'registered' to be given to humans."
About 350 people admitted to John Hunter Hospital each year develop blood poisoning while in hospital.
Blood poisoning is treatable but one in five infected die, about half from the blood poisoning and others from associated illnesses.
Nationally, it is estimated there are 12,000 hospital-acquired septicaemia (blood poisoning) cases each year and up to 400 deaths.
The study mainly involved patients receiving blood after general surgery, kidney disease, obstetrics and other medical admissions.
"If ... you're otherwise healthy then you're less likely to get sepsis," Dr O'Mara said. "It's the sicker people it really affects."
Hunter Area Pathology Service senior staff specialist Dr John Ferguson and Michael Manolis were co-authors of the study.
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