Current Status of Red-Cell Preservation and Availability in Relation to the Developing National Blood Policy

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Abstract
The new National Blood Policy focuses attention on unsettled questions concerning current quality and availability of preserved red cells. Expanded understanding of mechanisms of red-cell oxygen delivery has posed unresolved questions about the clinical effectiveness of transfusions of 2,3-diphosphoglyceratedepleted cells. The 21-day storage period approved 30 years ago has not been extended, despite evidence from laboratory experiments and clinical trials that improved methods for liquid preservation of whole blood have been developed. The appropriate role for prolonged subzero storage of glycerolized red cells remains controversial; claims for the product's superiority with respect to low hepatitis risk and reduced incidence of recipient sensitization to histocompatibility antigens require conclusive documentation. Periodic shortages of red cells reflect, in large part, inefficient management of total blood supplies and lack of co-ordinated donor-recruitment programs. These problems must be resolved to assure adequate supplies and high quality of preserved red cells. (N Engl J Med 291:68–74, 1974)

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