Transfusions of 'Older' Blood Don't Work as Well

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"The biggest impact of a paper like this is that it is really a call to arms, coming from a well-established institute with some of the best cardiac surgery in the world," Rao said.

The Duke studies have shown that "blood undergoes changes profoundly, even in the first 24 hours," Rao said. The major effect is loss of nitric oxide, "which is really fundamental to the process of oxygen exchange," he said.

The Duke researchers are trying to get funding for a study in which nitric oxide would be added to transfused blood, to see whether that offers benefits over the long run, he said. "It needs to be tested in studies long enough to improve survival and outcome," Rao said.

While the various studies are considered and conducted, practical steps can be taken to reduce the need for transfusions, Koch said. Patients should be tested before surgery to determine if their hematocrit -- a measure of possible anemia -- is low enough to cause worry. "If there is anemia, you should find the source of it and treat it," she said.

The Cleveland Clinic is also using medication that decreases bleeding, and even gathers red cells that are washed and restored to the patient's body, she said.

More information

To learn more about transfusions and blood donations, visit the U.S. National Library of Medicine.