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I've summarized the data in this letter: https://www.bmj.com/content/366/bmj.l4968 In randomized trials, the fresher blood arm is associated with a higher incidence of nosocomial infection (immunomodulation, presumably). There has never been any data examining clinical outcomes that actually favors using very fresh blood. Mostly just "expert opinion" and "it seemed like a good idea." That's not good enough now, in my view. Two key references (one only published in abstract form) are: Alexander PE, Barty R, Fei Y, et al . Transfusion of fresher vs older red blood cells in hospitalized patients: a systematic review and meta-analysis. Blood2016;127:400-10. doi:10.1182/blood-2015-09-670950 pmid:26626995 Abstract/FREE Full TextGoogle Scholar ↵ Schmidt A, Gore E, Cholette JM, et al . Oxidation reduction potential (ORP) is predictive of complications following cardiac surgery in pediatric patients[abstract]. Transfusion2016;56(Supplement S4):20A-1A. Google Scholar

Our neonatal intensive care transfusions are all irradiated because many severe immunodeficiency states are not evident until weeks to months after birth. These are rare, and leukoreduced transfusions probably mitigate the risk of GVHD somewhat, but we are erring on the side of caution. We irradiate just before transfusion so the storage based problems with irradiated red cells are less of a concern. We define fresh as <21 days of storage, because the data suggest very fresh blood is actually more dangerous to patients than blood stored 7-21 days or so. Seat of the pants, to be sure, but somewhat data driven. No one knows for sure, but very fresh blood (<7 days storage) is totally unnecessary in terms of proven benefit and may actually be more dangerous, for reasons that are largely unknown.

No bad outcomes at all. So I suppose your next question would be " then why change anything?" Which would be a good question!

I looked at Quotient and Hemobioscience. Could not find that kit.