Clinical Outcomes of Left Ventricular Assist Device Implantation for Patients Refusing Blood Transfusion

Mortality and morbidity in non‐transfusable and transfusable patients: A systematic review and meta‐analysis

“…Of the 41 included studies, all were retrospective cohort studies by design, and seven were abstracts 16,22,23,34,39,45,46 . In the majority of studies, the non‐transfusable cohort referred to those declining transfusions for personal or religious reasons 14,16–54 . We identified one study where patients did not receive an option for transfusion, potentially due to limited resources 15 .…”

“…We collected information on the individual PBM strategies applied to manage anemia, bleeding, and coagulopathy (Table S5 to S7, Data S1). Of the 41 studies included, 26 described the application of strategies to manage anemia, 14,18,19,21,24–28,30,32–39,43–45,47,49,50,53,54 with a median of two strategies applied per study; 23 studies described the application of strategies to minimize bleeding, 14,17–20,24–30,33,37,38,40,43,44,47–49,52,54 with a median of two strategies per study; 15 studies described applying strategies for coagulopathy, 14,18,22,26,30,33,36–38,43,44,48,49,52,54 with a median of one strategy per study (Table S18, Data S1).…”

“…The number of patients in the non‐transfusable cohort ranged from four to 322, and from 14 to 136,326 in the transfusable cohort. The most common clinical setting studied was cardiac surgery ( n = 16), 14,18,22,25,29,34,37,38,42–45,48–50,52 followed by orthopedic surgery ( n = 8) 17,20,27,28,33,40,53,54 and urology ( n = 4) 16,26,31,35 . Other disciplines included in our systematic review were obstetrics and gynecology, hematology, critical care, internal medicine, cardiology, and trauma.…”

“…Data on short‐term mortality were provided in 35 of the 41 studies included in our review., 14,15,17–34,37–42,44,46–53 with 32 reporting in‐hospital mortality, and three 30‐day mortality. Of these, 12 reported zero deaths in both groups, 17,19,20,25–28,30,33,40,49,53 and the remaining 23 reported no significant differences between groups 14,15,18,21–24,29,31,32,34,37–39,41,42,44,46–48,50–52 . Eleven moderate risk of bias studies were included in the meta‐analysis of short‐term mortality (Figure 2).…”

“…We collected information on the individual PBM strategies applied to manage anemia, bleeding, and coagulopathy (Table S5 to S7, Data S1). Of the 41 studies included, 26 described the application of strategies to manage anemia, 14,18,19,21,[24][25][26][27][28]30,[32][33][34][35][36][37][38][39][43][44][45]47,49,50,53,54 with a median of two strategies applied per study; 23 studies described the application of strategies to minimize bleeding, 14,[17][18][19][20][24][25][26][27][28][29][30]33,37,38,40,43,44,[47][48][49]52,…”