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Evidence is emerging that blood that has been stored for longer periods may confer a higher risk for complications after transfusion than blood that has been obtained more recently. The mechanisms of such complications are not clear but may relate to cell damage, accumulation of proinflammatory substances, and nitric oxide depletion, among other possibilities. In a large observational study, investigators at the Cleveland Clinic compared 2872 cardiac-surgery patients who received blood within 2 weeks of donation with 3130 cardiac-surgery patients who received blood more than 2 weeks after donation.
Patients given older blood had a higher risk for in-hospital death than did those given newer blood (2.8% vs. 1.7%, P=0.004). They were also sign…