Comparative study of hemoglobin changes following transfusion of fresh and old blood in patients with thalassemia referred to Bahrami Hospital

INTRODUCTION: Thalassemia major is a severe hemoglobinopathy that requires blood transfusion; however, long term blood transfusion might increase morbidity and mortality. Hemoglobin (Hb) after transfusion determines the need for next transfusion. There is controversy regarding the effect of fresh packed RBC compared to old packed RBC transfusion on Hb. This study compared hemoglobin changes following transfusion between fresh and old packed RBC in transfusion-related thalassemia (TRT) patients. MATERIALS AND METHODS: In this cohort study, 140 TRT patients (age > 5years) referred to Bahrami Children's Hospital in mid-2013 were included. Equal number (n = 70) of age and gender matched TRT patients with exposure to fresh (stored for less than 7 days) and old (stored for more than 7 days) packed RBC transfusion were followed for 14 days. In both groups, demographic information (age, sex) were recorded at enrolment. Physical examination data and blood parameters, including red blood cells (RBC), white blood cells (WBC), platelets (PLT), Hb, ferritin, transferrin, total iron binding capacity and bilirubin at baseline and follow up. RESULTS: Time-group interaction was significant only for WBC (p < 0.001) and Hb (p = 0.029) indicating that fresh packed RBC transfusion resulted in higher Hb and lower WBC at follow up compared to baseline levels. Among the baseline variables only fresh packed RBC transfusion was found to increase the odds of having Hb of at least 1 mg/dL higher than baseline (OR = 15.465, p < 0.001). CONCLUSIONS: Fresh packed RBC transfusion might increase the interval between transfusions due to more Hb elevation rate after transfusion in thalassemia major.