• Martin A Schreiber, Belinda H McCully, John B Holcomb, Bryce R Robinson, Joseph P Minei, Ronald Stewart, Laszlo Kiraly, Nicole T Gordon, David T Martin, Elizabeth A Rick, Rondi K Dean, Connor Wiles, Nathan Anderson, Dennis Sosnovske, Ben Houser, Diane Lape, Bryan Cotton, Dina Gomaa, Michael W Cripps, Mark DeRosa, and Samantha J Underwood.
• *Department of Surgery, Oregon Health & Science University, Portland, OR †Department of Surgery, University of Texas at Houston, Houston, TX ‡Department of Surgery, University of Cincinnati, Cincinnati, OH §Department of Surgery UT Southwestern/Parkland Memorial Hospital, Dallas, TX; and ¶Department of Surgery, University of Texas San Antonio, San Antonio, TX.
• Ann. Surg. 2015 Sep 1;262(3):426-33; discussion 432-3.

ObjectivesTo determine the safety and efficacy of cryopreserved packed red blood cell (CPRBC) transfusion in trauma patients.BackgroundLiquid packed red blood cells (LPRBCs) have an abbreviated shelf-life and worsening storage lesion with age. CPRBCs are frozen 2 to 6 days after donation, stored up to 10 years, and are available for 14 days after thawing and washing. CPRBCs can be utilized in diverse settings, but the effect on clinical outcomes is unknown.MethodsWe performed a prospective, randomized, double-blind study at 5 level 1 trauma centers. Stable trauma patients requiring transfusion were randomized to young LPRBCs (≤14 storage days), old LPRBCs (>14 storage days), or CPRBCs. Tissue oxygenation (StO2), biochemical and inflammatory mediators were measured, and clinical outcomes were determined.ResultsTwo hundred fifty-six patients with well-matched injury severity and demographics (P > 0.2) were randomized (84 young, 86 old, and 86 CPRBCs). Pretransfusion and final hematocrits were similar (P > 0.68). Patients in all groups received the same number of units postrandomization (2 [1-4]; P > 0.05). There was no difference in the change in tissue oxygenation between groups. CPRBCs contained less α2-macrogobulin, haptoglobin, C-reactive protein, and serum amyloid P (P < 0.001). Organ failure, infection rate, and mortality did not differ between groups (P > 0.2).ConclusionsTransfusion of CPRBCs is as safe and effective as transfusion of young and old LPRBCs and provides a mechanism to deliver PRBCs in a wide variety of settings.

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