Transfusion
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Clinical trials have shown that longer red blood cell (RBC) storage duration does not worsen outcomes; however, these studies included few RBCs near the end of the 42-day storage limit. We tested the hypothesis that these "oldest" RBCs are associated with adverse outcomes. ⋯ RBCs transfused in the last 7 days of their 42-day storage limit may be associated with adverse clinical outcomes in high-risk patients.
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The acute treatment of severe warm autoimmune hemolytic anemia (wAIHA) is focused on maximizing the oxygen delivery capacity of the patient's circulation and reversal of the underlying autoimmune process. The most effective means of preventing ischemic injury acutely is replacement of red blood cells (RBCs) via allogeneic RBC transfusion. However, in cases where this is not an option, other strategies must be considered including the use of hemoglobin-based oxygen carriers (HBOCs). ⋯ Early recognition of the need and ready familiarity with its properties on the part of the physician are critical to the utilization of HBOC-201 in a safe and timely fashion.