Blood transfusion is associated with increased morbidity and mortality after lower extremity revascularization

O'Keeffe, Shane; Davenport, Daniel L.; Minion, David J.; Sorial, Ehab; Endean, Eric D.; Xenos, Eleftherios S.

doi:10.1016/j.jvs.2009.10.045

Cited by 80 publications

(54 citation statements)

References 35 publications

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“…anesthetized anemic sheep where transfusion of renitrosylated RBCs, but not untreated blood, increased kidney blood flow and maintained GFR. Intraoperative blood transfusion is a well-recognized risk factor for acute kidney injury (AKI) (43)(44)(45), and the incidence of transfusion-associated AKI is amplified by preoperative anemia (44). Thus, occurrence rates of AKI may be a useful measure of the O 2 delivery capability of banked blood.…”

Section: Discussionmentioning

confidence: 99%

S-nitrosylation therapy to improve oxygen delivery of banked blood

Reynolds¹,

Bennett²,

Cina

et al. 2013

Proc. Natl. Acad. Sci. U.S.A.

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From the perspectives of disease transmission and sterility maintenance, the world's blood supplies are generally safe. However, in multiple clinical settings, red blood cell (RBC) transfusions are associated with adverse cardiovascular events and multiorgan injury. Because ∼85 million units of blood are administered worldwide each year, transfusion-related morbidity and mortality is a major public health concern. Blood undergoes multiple biochemical changes during storage, but the relevance of these changes to unfavorable outcomes is unclear. Banked blood shows reduced levels of S-nitrosohemoglobin (SNO-Hb), which in turn impairs the ability of stored RBCs to effect hypoxic vasodilation. We therefore reasoned that transfusion of SNO-Hb-deficient blood may exacerbate, rather than correct, impairments in tissue oxygenation, and that restoration of SNO-Hb levels would improve transfusion efficacy. Notably in mice, administration of banked RBCs decreased skeletal muscle pO 2 , but infusion of renitrosylated cells maintained tissue oxygenation. In rats, hemorrhage-induced reductions in muscle pO 2 were corrected by SNO-Hb-repleted RBCs, but not by control, stored RBCs. In anemic awake sheep, stored renitrosylated, but not control RBCs, produced sustained improvements in O 2 delivery; in anesthetized sheep, decrements in hemodynamic status, renal blood flow, and kidney function incurred following transfusion of banked blood were also prevented by renitrosylation. Collectively, our findings lend support to the idea that transfusions may be causally linked to ischemic events and suggest a simple approach to prevention (i.e., SNO-Hb repletion). If these data are replicated in clinical trials, renitrosylation therapy could have significant therapeutic impact on the care of millions of patients.ethyl nitrite | hemoglobin cysbeta93 | nitric oxide | storage lesion

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Section: Discussionmentioning

confidence: 99%

S-nitrosylation therapy to improve oxygen delivery of banked blood

Reynolds¹,

Bennett²,

Cina

et al. 2013

Proc. Natl. Acad. Sci. U.S.A.

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“…[3][4][5] In a study based on National Surgical Quality Improvement Program (NSQIP) report, dialysis requiring AKI after revascularization occurred in 0.5% of patients, and 30-day mortality was 2.7%. 19 There is no data available on the prevalence of less severe stages of AKI (non-dialysis requiring).…”

Section: Discussionmentioning

confidence: 99%

Low levels of high-density lipoproteins are associated with acute kidney injury following revascularization for chronic limb ischemia

Arora¹,

Davari-Farid²,

Gannon³

et al. 2013

Renal Failure

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.001) were independently associated with increased odds for developing AKI. Propensity score analyses showed low HDL was independently associated with increased odds of AKI (OR 2.4 (1.4-4.2)). Conclusions: AKI following revascularization is not uncommon (12.0%), and lower concentrations of HDL and serum albumin are associated with increased odds of postoperative AKI. There was also a trend of higher prevalence of AKI among those with pre-existing CKD.

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“…This is considered as an independent risk factor that increases peri-operative adverse outcomes [5,7]. Many studies demonstrated that there was an increased risk of postoperative mortality and morbidity including pulmonary and infectious complications after receiving intraoperative blood transfusions [8][9][10]. Thus, there has been an increased emphasis on the correction of preoperative anaemia to improve the patient's outcome and decrease the need for allogeneic blood transfusion.…”

Section: Design Overviewmentioning

confidence: 99%

A Prospective Randomized Controlled Trial to Assess the Effect of Intravenous versus Oral Iron Therapy in the Treatment of Preoperative Anaemia

Khalafallah¹,

Al-Barzan²,

Chan³

et al. 2012

J Blood Disord Transfus

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Background: Improving preoperative anaemia is associated with a better surgical outcome. There is lack of data regarding treatment of preoperative anaemia with intravenous versus oral iron.Objective: Assessment of efficacy of oral iron sulphate versus a single intravenous iron polymaltose and subsequent effect on perceived quality of life in both treatment groups. Patients and methods:We conducted a prospective randomised controlled trial with iron therapy for the treatment of Iron Deficiency Anaemia (IDA) patients who were undergoing elective joint arthroplasty. At a single institution, we recruited 44 patients who were randomized to a single intravenous iron polymaltose infusion (16/22) versus oral daily iron sulphate (17/22). Median age was 68 years (range, 45-91) with a male to female ratio of 14:19.

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Blood transfusion is associated with increased morbidity and mortality after lower extremity revascularization

Cited by 80 publications

References 35 publications

S-nitrosylation therapy to improve oxygen delivery of banked blood

S-nitrosylation therapy to improve oxygen delivery of banked blood

Low levels of high-density lipoproteins are associated with acute kidney injury following revascularization for chronic limb ischemia

A Prospective Randomized Controlled Trial to Assess the Effect of Intravenous versus Oral Iron Therapy in the Treatment of Preoperative Anaemia

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