Blood Storage

Efficacy and Safety of Frozen Red Blood Cells for Transfusion in Trauma Patients

Principal Investigator: Martin Schreiber, MD

What is the Blood Storage study?

We have initiated a prospective, randomized, multi-center study at five hospitals around the country. The purpose of this study is to compare cryopreserved, or frozen, red blood cells (RBCs) to standard refrigerated RBCs. Three comparisons will be made: 1) frozen RBC to standard RBCs up to 14 days old (newer RBCs); 2) frozen RBCs to standard RBCs greater than 14 days old (older RBCs); 3) newer RBCs to older RBCs. We hypothesize that frozen RBCs will be superior to older RBCs, but not inferior to newer RBCs with respect to physiologic, biochemical, and clinical parameters.

Why do this study?

Anemia is a common problem in traumatically injured adults and has important prognostic implications for morbidity and mortality. These patients receive approximately 15% of blood transfused in the United States. During preservation under standard blood bank conditions, donor red blood cells (RBCs) expire after 42 days and undergo a series of functional and structural changes (referred to as a "storage lesion"), which manifests with various speeds as the age of the cells differ. This storage lesion includes alteration of nitric oxide (NO) metabolism, loss of NO bioactivity, depletion of 2,3-Diphosphoglycerate, changes in morphology, and increased frequency of hemolysis. Increased age of RBCs is associated with increased patient mortality, length of stay, infectious complications, and rates of organ failure. During periods of high demand and low donation, banked blood is often close to expiration. Frozen blood represents a possible method of solving this problem by avoiding the storage lesion without reducing the available blood supply.

Who will be included?

Trauma patients who may require non-emergent blood transfusion are eligible to participate.

What is involved?

Eligible participants are randomized to receive frozen RBCs, newer RBCs, or older RBCs. During the transfusion, participants wear a monitor on their hand to measure tissue oxygenation before, during, and up to 12 hours after the end of the transfusion. Additionally, a small blood sample before and after each unit transfused will be collected to look at biochemical and coagulation markers that may correlate with changes in tissue oxygenation.

For more information, contact Samantha Underwood at 503 494-8481 or email at