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This article provides information on the intentional transfusion of expired blood products. It discusses a study that found a small percentage of blood products transfused in US combat theaters were expired, with red blood cells being the most common expired product. The article explores the use of expired products in rare medical situations and the lack of clear guidance on their use. It also discusses the standards and regulations set by organizations like the AABB and FDA regarding the use of expired products. The article emphasizes that while current standards are conservative, exceptions can be made when clinically indicated. Additionally, the article provides information on the storage and expiration of red blood cells in different solutions and containers, including the development of various solutions and the benefits of storing blood products in plastic bags. It also discusses the potential utility of transfusing expired blood products in certain situations, based on studies that have assessed the quality and hemostatic function of long-stored blood products. However, the article acknowledges that further evaluation of clinical outcomes and safety is needed. [Extracted from the article]

Background: Intrauterine transfusion (IUT) is an invasive but critical and potentially life‐saving intervention for severe fetal anemia with demonstrated improvement in outcomes. The fetus is vulnerable to hemodynamic alterations and transfusion‐related adverse events; therefore, special consideration must be given to blood component selection and modification. There is widespread IUT practice variability, and existing guidance primarily relies on expert opinion and single center experiences. Study Design and Methods: Experts in Maternal Fetal Medicine, Pediatric Hematology, and Transfusion Medicine from centers across the United States, collectively performing about 120 IUT annually, offer a multidisciplinary perspective on the performance of IUT and preparation of blood components. This perspective includes strategies for identifying an at‐risk fetus, communicating between disciplines, determining the necessary blood volume, selecting and processing blood components, documenting the procedure in medical record, and managing the neonate. Results: Identifying an at‐risk fetus relies on review of the clinical history, non‐invasive monitoring, and laboratory evaluation. We recommend the use of relatively fresh, group O, cytomegalovirus‐safe, freshly irradiated, red blood cells (RBC) that are Hemoglobin S negative and antigen‐negative for any maternal antibody, if indicated. These RBC units should be concentrated to remove additives and increase the hematocrit thus minimizing fluctuations in fetal volume status. The units intended for IUT should be labeled clearly and the documentation of transfusion differentiated in the maternal medical record. Discussion: An awareness of the technical, logistical, and regulatory considerations for IUT performance will facilitate improved communication and patient care, especially when rare units of RBC are required. [ABSTRACT FROM AUTHOR]