Spinella et al. present an interesting and though-provoking paper that may turn current thinking about blood transfusion upside down. They demonstrate in a retrospective study that military combat casualty patients who were transfused with warm fresh whole blood had a better 30-day survival than comparable patients who were treated with stored blood components. Although these findings need to be confirmed in an adequately designed prospective study, and leukocyte-reduced stored blood should be used as a better comparator, these findings are very relevant and may fit the current thinking about the disadvantages of storing blood and blood components for a prolonged period.

– Marcel Levi