Australian blood expert calls for changes in the way blood is stored

Mar 25 2008

A leading Australian haematologist is renewing his call for changes in the way blood is stored and used for transfusions.

Professor James Isbister, a Clinical Professor of Medicine at the University of Sydney, Adjunct Professor, at the University of Technology, Sydney and an emeritus consultant Hematologist at Royal North Shore Hospital of Sydney, says research has revealed that blood deteriorates with age and creates problems for patients.

Professor Isbister says maintaining the supply of blood from different donors has always been a challenge and it is difficult to ensure and monitor how long it remains of value; he says there is sound evidence that older blood presents problems compared with blood that is less than two weeks old.

Professor Isbister says research in the U.S. involving 6,000 patients undergoing heart surgery, has raised serious issues regarding the shelf life of blood and its effects on patients - the research revealed that those who had transfusions using blood that was more that 14 days old had more complications than those who received fresh blood.

Isbister says transfusions should be avoided unless there is a good reason, and doctors and patients must consider this.

Professor Isbister believes a patient's own blood is a valuable and unique natural resource that should be conserved and managed appropriately and donated allogeneic blood should only be used when there are no other alternatives.

Current practice in Australia involves donated blood being refrigerated and sent to hospitals and other health care providers within two weeks, but under Red Cross standards, supplies can be stored for up to six weeks.

He says recent evidence suggests there are significant under-recognised hazards of transfusion in which the benefit is difficult to confirm and he questions the current focus on the supply side of the blood transfusion chain rather than the clinical problems facing patients and doctors.

Professor Isbister emphasizes the importance of regular interaction and information exchange of hematological and transfusion medicine knowledge with other medical specialties and is passionate about the appropriate, safe and cost effective use of blood component therapy and has been a long time advocate of patient blood management.

Professor Isbister suggests that removing the white cells from all red blood products would both improve storage and lessen the risks and he would like to see such a decision made at a meeting of health ministers next month.

Professor Isbister says the appropriateness of transfusion practices will only improve with better patient blood management.

Professor Isbister has been associated with Sydney's Royal North Shore Hospital since 1980, and was the head of department of hematology and transfusion medicine from 1982-1996.

He is currently Chair of the Advisory Committee and Board Member of the Australian Red Cross Blood Service and a board member of the Society for the Advancement of Blood Management (SABM) and the Medical Society for Patient Blood Management.