October 13, 2016

AABB publishes updated RBC transfusion guidelines

By: Judy Mathias

Editor's Note

The AABB has published updated recommendations to assist clinicians in decisions on red blood cell (RBC) transfusion. The original recommendations were released in 2012.

The update, titled “Red blood cell transfusion: 2016 clinical practice guideline from the AABB,” includes two main recommendations:

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  • Restrictive RBC transfusion thresholds:

         −A restrictive RBC transfusion threshold of 7 g/dL in hospitalized hemodynamically stable adult patients, including critical care patients, rather than 10 g/dL.

         −A restrictive RBC transfusion threshold of 8 g/dL for patients undergoing orthopedic surgery, cardiac surgery, and those with pre-existing cardiovascular disease.

  • RBC storage duration:

         −Patients, including neonates, requiring transfusions should receive standard issue (ie, selected at any point within their licensed dating period) rather than fresh RBC units (ie, stored for less than 10 days).


Importance More than 100 million units of blood are collected worldwide each year, yet the indication for red blood cell (RBC) transfusion and the optimal length of RBC storage prior to transfusion are uncertain. Objective To provide recommendations for the target hemoglobin level for RBC transfusion among hospitalized adult patients who are hemodynamically stable and the length of time RBCs should be stored prior to transfusion.


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