In this rat model of hemorrhagic shock resuscitated with blood, the authors observed increased liver injury (liver necrosis and enhanced apoptosis, altered liver perfusion) after transfusion of stored, old RBCs (7 days), compared with fresh RBCs or RBCS stored for a maximum of 4 days. Unfortunately, the authors used whole blood units in their study and RBCs were stored in CPDA-1. These deviations from usual practice limit interpretation of the results of this study and prevent even a prudent extrapolation of the results to the clinical context.

– Michael Piagnerelli