The impact of storage time of transfused blood on postoperative infectiouscomplications in rectal cancer surgery

Background: We have studied the impact of storage time of transfused alloge neic blood together with other known risk factors on postoperative infectio us complications after operation for rectal cancer. Methods: Intra-abdomina l abscess, anastomotic leakage, septicaemia, wound infection, and pneumonia were prospectively recorded in 303 patients undergoing elective resection for primary rectal cancer in 18 Danish hospitals. Patient risk variable and variables related to operation technique and transfusion were recorded pro spectively, whereas amount given before infectious complication and storage time of saline-adreine-glucose-mannitol (SAGM) blood, administered to each patient, were recorded retrospectively. Results: The overall infection rat e was 24% in 78 non-transfused and 40% in 225 transfused patients (P = 0.01 1). The proportion of SAGM blood stored for greater than or equal to 21 day s administered to each transfused patient was a median of 60% in patients d eveloping postoperative infections versus 25% (P = 0.037) in patients witho ut infections. A multivariate analysis of significant risk variables showed weight >75 kg (odds ratio, 2.0 versus <65 kg) and transfusion of SAGM bloo d scored greater than or equal to 21 days (odds ratio, 2.5 versus no transf usion) to be independent variables predicting infectious complications. Con clusion: Blood storage time may, along with other risk factors, play a sign ificant role in blood transfusion-assosiated development of postoperative i nfectious complications.