Peyrard T, Pham B N, Le Pennec P Y, Rouger P
National Institute of Blood Transfusion, National Reference Laboratory for Blood Groups, National Institute for Health and Medical Research, Inserm Unit UMR_S665/Diderot-Paris 7 University, Paris Cedex 11, France.
Immunohematology. 2009;25(1):13-7.
The technology allowing freezing of RBC units has been available for many decades. The high-glycerol method for RBC storage at -8 degrees C is predominantly used. Several studies have shown satisfactory results regarding the in vitro viability and function of cryopreserved RBCs. RBC freezing is nowadays mostly encountered in rare blood programs and military deployments. Preservation time of frozen RBCs appears to be virtually indefinite, but most countries apply a 10-year outdate. There is no mandatory time restriction in France. The National Rare Blood Bank currently includes 962 (17.5%) RBC units aged to years or more and 153 (2.8%) aged 20 years or more. Since 1994, 1957 RBC units have been thawed and transfused, among which 118 were aged 10 years or more and 8 were aged 20 years or more. Discarding RBC units older than to years may be highly sensitive for very rare blood groups, e.g., U-, of which approximately 30 percent of the cryopreserved units are aged to years or more. However, the lack of nucleic acid testing for HIV and HCV may be problematic for old RBC units drawn from donors who were not subsequently tested for these markers, which is now mandatory in most countries. Regarding the 118 transfused RBC units older than 10 years, no evidence of hemolysis of thawed RBCs and no transfusion reaction, clinical or biologic hemolysis, or transfusion ineffectiveness was reported, either by any of the parties involved in the transfusion supply of rare RBC units or through the French hemovigilance program, which requires a mandatory report of any transfusion reaction. It has recently been suggested to extend the 10-year restriction in some countries. Considering our experience and observational data, we may consider it safe and efficient to transfuse rare frozen RBC units older than 10 years. An international consensus for RBC cryopreservation time should ideally be established.
红细胞单位冷冻技术已经存在数十年了。主要采用高甘油法在-8℃储存红细胞。多项研究表明，冷冻保存的红细胞在体外活力和功能方面取得了令人满意的结果。如今，红细胞冷冻主要出现在稀有血型计划和军事部署中。冷冻红细胞的保存时间似乎实际上是无限期的，但大多数国家规定有效期为10年。法国没有强制的时间限制。国家稀有血型库目前有962个（17.5%）红细胞单位储存了10年或更长时间，153个（2.8%）储存了20年或更长时间。自1994年以来，已有1957个红细胞单位被解冻并输注，其中118个储存了10年或更长时间，8个储存了20年或更长时间。对于非常稀有的血型，如U-血型（其冷冻保存单位中约30%储存了10年或更长时间），丢弃超过10年的红细胞单位可能非常敏感。然而，对于从未接受过这些标志物后续检测的献血者所采集的旧红细胞单位，缺乏对HIV和HCV的核酸检测可能会有问题，而现在大多数国家这是强制性要求。关于118个储存超过10年的输注红细胞单位，无论是稀有红细胞单位输血供应的任何相关方，还是通过法国血液警戒计划（该计划要求强制报告任何输血反应）报告中，均未发现解冻红细胞溶血证据、输血反应、临床或生物学溶血或输血无效的情况。最近有人建议在一些国家延长10年的限制。考虑到我们的经验和观察数据，我们可能认为输注超过10年的稀有冷冻红细胞单位是安全有效的。理想情况下，应该就红细胞冷冻保存时间达成国际共识。
