Clinical trial of young red cell transfusions.

The lower mean cell age and prolonged 51Cr-labeled red cell survival of the top layer of centrifuged red blood cells suggest that this product may reduce blood requirements in patients with transfusion-dependent anemias. In a prospective clinical trial, we compared the effect of regular administration of young red cells with that associated with use of conventional frozen cells. Six patients with thalassemia major received 192 units of young red cells prepared from single donor units of whole blood using the IBM 2991 Cell Processor. The mean transfusion requirement to maintain the hemoglobin level greater than 9.0 gm/dl was 110 +/- 17 ml RBC/kg during the year of young cell transfusions, in comparison with 130 +/- 20 and 131 +/- 23 ml RBC/kg when conventional frozen cells were administered in the years before and after the young cell trial, respectively. Blood requirements in individual patients were reduced by 8% to 24% (mean 15.8%); the hemoglobin level remained constant. Although young cells of consistent quality can be prepared regularly in a clinical setting with little difficulty, the cost of the product is high and the effect on transfusion requirements is less than predicted from studies in vitro and from labeling experiments.