Study cites risks of older stored blood
The heart surgery findings add to the growing concern about the safety of hospital transfusion practices.
By Thomas H. Maugh II, Los Angeles Times Staff Writer
4:43 PM PDT, March 19, 2008
Heart surgery patients who received transfusions of blood stored for more than two weeks were 64% more likely to die in the hospital than those who received fresher blood, a finding that adds to the growing concern about the safety of transfusion practices.
Several small studies have already suggested a danger in using blood that is nearing its expiration date, but a report to be published Thursday is by far the largest, with more than 6,000 patients enrolled.
In response to the growing concern, some hospitals have modified their procedures for cardiac surgery -- one of the largest consumers of donor blood -- to minimize the need for transfusions.
New practices include increased use of blood scavenging during surgery, sending patients home with a lower-than-normal percentage of red cells in their blood, new drugs to prevent intra- and post-operative bleeding and, perhaps most important, reducing anemia before surgery.
Some researchers are also attempting to rejuvenate older blood by reinfusing it with nitric oxide, a crucial ingredient for delivering oxygen to tissues that has been shown to disappear during storage.
Many of the conservation techniques were originally developed because of fears about AIDS and other infectious agents in blood, but they have become doubly important now because of concerns about the blood itself, said Dr. Richard Shemin, chief of cardiothoracic surgery at UCLA's Geffen School of Medicine.
"We now have very good data that shows being exposed to any blood does have a potential for harm," he said.
But any regulatory changes are unlikely in the near future.
A statement today by the Food and Drug Administration noted that the new study in the New England Journal of Medicine was "narrow and non-randomized," and that any regulatory actions would be "premature."
And any action to reduce the shelf life of donor blood would significantly impair supplies, said Dr. Ross Heron, medical director of the American Red Cross. "I don't know if we would be able to get enough blood donors to offset that," he said.
More than 14 million units of blood are transfused every year in the U.S. Regulations let it be stored for as long as six weeks, which allows time to ship it across the country and provides a cushion against shortages. Most blood banks operate on a "first in, first out" basis, so that patients typically receive the oldest blood available. The median storage time of transfused blood is 15 days.
Because of worries about blood, Dr. Colleen Gorman Koch and her colleagues at the Cleveland Clinic looked at the records of 6,002 cardiac surgery patients who received transfusions from June 1998 to January 2006. About half had received blood that had been stored for 14 days or less, and the rest received blood stored for longer periods.
About 2.8% of those who received older blood died in the hospital, compared with 1.7% of those who received fresher blood. The rates of prolonged intubation for breathing problems, kidney failure and infections were also significantly higher in those who received older blood.
At one year after surgery, 11% of those receiving older blood had died, compared with 7.4% of those receiving fresher blood.
The older the blood, the higher the risk, Koch said.
"This is a very important outcome," wrote Dr. John W. Adamson of UC San Diego in an editorial accompanying the report. "The results will arm those who believe that transfusion of older red-cell units carries risks and should be avoided."
The findings won't, and shouldn't, change FDA policy because the study is retrospective, Koch said. To get around that problem, her group has begun a prospective study that will be randomized and blinded -- "the gold standard," she said.
The study will involve a minimum of 2,000 patients, and results should be available in two to 2 1/2 years.
A variety of possible explanations for the risks of aging blood have been offered, in addition to the theory of nitric oxide loss.
The surface membranes of fresh red blood cells are very flexible, which allows them to deform to slip through the tiniest capillaries in the body. As the cells age in storage, the membrane becomes stiffer, increasing the possibility that the cells might block small conduits.
The cells also become stickier, increasing the likelihood of a clot.
"We are only now starting to realize what happens to blood when it is drawn out of a human body and sent to the blood bank for storage," said Dr. Sunil Rao of Duke University.
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Borgia
JoinedPosts by Borgia
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5
Study cites risks of older stored blood
by skeeter1 instudy cites risks of older stored blood
the heart surgery findings add to the growing concern about the safety of hospital transfusion practices.
by thomas h. maugh ii, los angeles times staff writer 4:43 pm pdt, march 19, 2008 heart surgery patients who received transfusions of blood stored for more than two weeks were 64% more likely to die in the hospital than those who received fresher blood, a finding that adds to the growing concern about the safety of transfusion practices.
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Borgia
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JW LOOPHOLE ON BLOOD IN PRINT!!
by Burger Time inok just read this article and didn't see it anywhere else.
anyways in this article the liason committee gives permission for a "forced" transfusion.
the article basically points out the loophole!!
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Borgia
It is a very nice written article, very well showing the moral conundrum the jw stance puts medical staff, parents who wish to adhere to an untenable position, the consequences for the child in question, and the call upon the expensive and overstretched judicial system....
I have discussed this issue with my fil who is the chiefpriest here in our cong. I flatly explained to him that although a grown person may hold certain values, how debatable and dangerous they may be, is basically their choice in life. However in the case of the child the WT is basically speaking out of two and 3 corners of their mouth. One way is the way in this article. When the government does interfere they go to court (sextuplets an vancouver case or the governmental denial of permission to adopt due to the blood stance). He sat there quite unsettled on his chair but had to admit this was so. From a moral point of view he could see where this was going but he said he had to adhere to organisational rules. To which I inquired: what would Jesus during his earthly ministry have said about such a proceeding...........And now to something completely different...
Cheers
Borgia -
99
It is official. I am an elder now!
by outofthebox init happened last night guys.
i got early to the kh and the boe came to talk to me.
they ask me to read the bible and asked me a couple of questions.
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Borgia
Your avatar and screen name in connection with your current JW position......
.....in a certain light quite funny. A real out of the box approach........
Good luck and keep us posted about your experiences.
I'd say though that the paedophile question is rather peculiar because they only pose it right before the announcement.....as if it is nothing. (relating to both the question and position.....
Cheers
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42
Evidence of Jesus Outside the New Testament (long article)
by lovelylil in.condemned him to be crucified, those who had .
finally, the claim that on the third day jesus appeared to his disciples restored to life, inasmuch as it affirms jesus' resurrection, is quite unlikely to come from a non-christian!.
we read that he was a wise man who performed surprising feats.
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Borgia
I made a separate thread to give you the opportunity to make your case xjw4vr and I'm sure we'll get some interesting responses.
XJW4EVR 's list of believes in invisbile......
Cheers
Borgia -
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Evidence of Jesus Outside the New Testament (long article)
by lovelylil in.condemned him to be crucified, those who had .
finally, the claim that on the third day jesus appeared to his disciples restored to life, inasmuch as it affirms jesus' resurrection, is quite unlikely to come from a non-christian!.
we read that he was a wise man who performed surprising feats.
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Borgia
Lovelylil,
I second your thought that a lot of people would believe in God even without a bible.......because it is a feature that can be seen in any culture.....
Without the bible, ancient Egyptians believed in a Sun-God. Indians still believe in Vishnu & Krishna.
However, that is no reason why believe in the biblical theology should be any more justified than those of the Hindu's or Buddhist even though they may vent concepts or morality on par with those of Christianity. and in the case of JC, it is just mind boggling that the biggest event in history is so poorly documented, although the era itself is very well documented.
Cheers
Borgia -
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My life - A brief history. Part 3 (conclusion)
by Galileo inthis is part 3 and the conclusion to my journey out.
part 1 can be found here, and part 2 is here.. .
truth.
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Borgia
Galileo,
Lot's wife looked back to the things behind her, no? and became a pillar of unmovable salt......perhaps that's what happens when people stick living in the past, allegorically speaking that is. To a degree it will be excusable because a person needs to get things out of his system and I sure hope this writing of you will do just that for you.
On the other hand I do hope in the last 2 to 3 years you have found a heading.....please, do write your epilogue.
Cheers
Borgia -
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Who lets it be known that they were once a JW?
by lfcviking ini am curious, for those of us here who have left the jw org, who actually lets it be known to people that they were once a practicing jw.. for me, this is something i tend to keep quiet because it is something i'm not particularly proud of.
anyone else feel the same way?.
lfcv.
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Borgia
lfcviking, I should say, you may be very proud of the fact you have broken with that backward cult. It is an accomplishment.
When I get to speak about the fact I virtually said adios to that believe system, people tend to be interested in knowing why. And basically, they are not surprised to learn a stronger support to the notion the JW are a cult.....It happens very often we share some of the same ideas to leave behind religion all together...So ,I can only say: very positive responses....
Cheers
Borgia -
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The "Historical Jesus" and Christian Faith
by Narkissos inin the wake of lovelylil's recent threads on the "historical jesus," a side question.. let's assume, for the sake of the discussion, that the four canonical gospels are not historical accounts of jesus' life, but a much later elaboration of christian faith in narrative form -- there are many reasons for such a proposal, but i'm not going into them right now -- let's just assume.. what do you think would be better or worse to find out in the historical field, from the perspective of christian faith:.
1. that there was no "historical jesus" at all, and that the gospels are essentially a religious myth made (hi)story, "the word made flesh" so to say;.
2. that there was a "historical jesus" completely different from the christian saviour -- for example, a galilean apocalyptic prophet and political zealot, trying to cleanse the nation and the temple from both the roman occupation and ritual disorders, with no interest at all in starting a new universal (i.e.
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Borgia
IMO, faith and especially Christian faith has nothing to do with historical fact.
The NT itself focusses on the weak point of the whole story by only denouncing opinion contrary to the historicity of the dealings of JC like 1 John without giving so much of a single shred of evidence. Historical JC deniers are to be evaded and not to be received in ones house or even greeted.
Paul's writings suffer from the same ailments. i.e 1 Kor 15 about the resurrections is a classic. Instead of saying hello to long list of faithful, he'd done better to sum up the names of the ones still alive who were witnesses to the resurrections of JC. Case in point is Paul himself because he claims to be a witness to JC's resurrections, thus enforcing the idea of an historical Jesus, due to his alleged encounter on the road to Damascus. But nothing has been furnished to that effect. What we are presented are the stories based on contemporary and older traditions like Krishna and Mithra who share an almost chilling resemblance with the life and times of JC.
Justin Martyr too had noticed this and simply dismissed the critique with a slight of hand saying: "the devil did it".
Whatever the outcome on your question Narkissos, I would say, it makes no difference. People will cling to that what has been ingrained into them for 2000 years. To undo it, we might need some more time than just a few years of enlightenment at the beginning of the 21st century.
Cheers
Borgia -
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Borgia
What a relieve! I now know the difference between overly and extremely casual is. OMG I seriously need to review my wardrobe!
This is really food at the proper time. In my prayer tonight I will request of Jehober that he will bless the GB and the FDS and I will express my sincere appreciation for all the hard work that is done to foster the kingdom interest!
What a daft bunch of twits!
Cheers
Borgia -
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WTBTS False Teaching re Why Adam Ate Fruit...
by AGuest into the household of god, israel, and those who go with... may you all have peace!.
according to the understanding and teachings of the wtbts, adam ate from the tree of knowledge of good and bad because... eve had eaten and was going to die and adam, who had been by himself for a long time before eve came along, chose to die with eve - he loved her so much and did not want to live without her or be alone.
sounds good, doesn't it?
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Borgia
Nice allegory, that genesis account of Adam & Eve. So, they became aware, had their consciousness raised but Jehober did not like it none. Sounds like the Prometheus gotspe who stole fire from the gods to teach humankind. But....the gods could not set the clock back....
looking at it from that perspective, it must be really hell to be a god in heaven at all.
Cheers
Borgia