Red blood cell transfusion in the elderly: the search for transfusion triggers

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Over the past three decades, our knowledge regarding the optimal use of red blood cell transfusions has greatly expanded. The risk of contracting chronic viral infections has significantly decreased; elderly transfusion recipients are much more likely to experience harm from noninfectious complications of transfusion, particularly circulatory overload. The traditional goal of maintaining hemoglobin levels at 10 g/dl or greater has been abandoned in the face of increasing evidence favoring a more restrictive transfusion strategy targeting hemoglobin levels of 7–8 g/dl. We do not yet know the optimal transfusion strategy for all geriatric patients, and data addressing the transfusion needs of important patient subgroups is still quite limited.

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