Randomized Trial Comparing Packed Red Cell Blood Transfusion With and Without Leukocyte Depletion for Gastrointestinal Surgery

Tartter, Paul Ian; Mohandas, Kala; Azar, Penny; Endres, Jill Canin; Kaplan, Jess L.; Spivack, Morton; Walsh, Patrick C.

doi:10.1016/s0022-5347(05)68385-1

Cited by 48 publications

(124 citation statements)

References 14 publications

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“…The detrimental effects of intraoperative blood loss and increased perioperative transfusion requirements in LT patients have been assessed in several studies, which showed a correlation between blood use and postoperative morbidity and mortality rates. 25 Some studies have reported a high mortality rate secondary to infectious complications in general, 26,27 particularly in patients who had received blood transfusions, 28 which is regarded as a strong contributor to morbidity and mortality. 29 George and associates 30 reported that RBC transfusion of as little as 2 units increased the risk for early abdominal or wound infection.…”

Section: Discussionmentioning

confidence: 99%

Effects of Blood Products on Nosocomial Infections in Liver Transplant Recipients

Özkardeşler

Avkan-Oğuz²,

Akan³

et al. 2013

Exp Clin Transplant

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Objectives: Infection is the most severe complication after an organ transplant. Blood cell transfusion is an independent risk factor for adverse events, including infection in the recipient. This study sought to evaluate the effect of blood product transfusions on nosocomial infections in liver transplant patients. Materials and Methods: Patients who underwent a liver transplant at our hospital between 2003 and 2010 were recruited for this study. Exclusion criteria were incomplete records, patients who were hospitalized for more than 48 hours during the 4 weeks before transplant, and pediatric transplants. Incidence of nosocomial infections, which were defined as infections occurring within 30 days after transplant was the primary endpoint. Results: The incidence of nosocomial infections was 28.7%. The number of transfusions of packed red blood cells and fresh frozen plasma was significantly higher in patients with nosocomial infection compared with patients without nosocomial infection (P = .018 and P = .039). Blood products dose-dependently contributed to nosocomial infections. Transfusions of ≥ 7.5 units of red blood cells (odds ratio: 2.8) or ≥ 12.5 units of fresh frozen plasma (odds ratio: 3.27) were associated with nosocomial infections (P = .042 and P = .015). The infection-related mortality rate was 10.3%. Conclusions: Blood product transfusions are associated with an increased rate of nosocomial infections, which contributes to higher morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Effects of Blood Products on Nosocomial Infections in Liver Transplant Recipients

Özkardeşler

Avkan-Oğuz²,

Akan³

et al. 2013

Exp Clin Transplant

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“…33 Surgical patients receiving allogeneic transfusions develop impaired cellular immunity [34][35][36][37][38] associated with increases in postoperative bacterial infections, [39][40][41][42] cancer recurrence, 43,44 multiorgan failure, [45][46][47][48][49][50] and poorer wound healing. [51][52][53] Could ABO nonidentical transfusions cause impaired cellular immune function, infection, and multiorgan failure, but by a different mechanism than that causing hemolysis?…”

Section: Transfusion Studiesmentioning

confidence: 99%

What would Karl Landsteiner do? The ABO blood group and stem cell transplantation

Heal

Liesveld

Phillips

et al. 2005

Bone Marrow Transplant

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Summary:ABO blood group antigens, of great importance in transplantation and transfusion, are present on virtually all cells, as well as in soluble form in plasma and body fluids. Naturally occurring plasma IgM and IgG antibodies against these antigens are ubiquitous. Nonetheless, the ABO blood group system is widely ignored by many transfusion services, except for purposes of red cell transfusion. We implemented a policy of transfusing only ABO identical platelets and red cells in patients undergoing stem cell transplantation or treatment for hematologic malignancies. Major bleeding episodes have occurred in about 5% of patients undergoing induction therapy for acute leukemia as compared with 15-20% in the literature. Overall survival times appear to be superior to that in historical cohorts. In 2002-2004, treatment-related mortality at 100 days in our Blood and Marrow Transplant Unit was 0.7% for autologous transplants (n ¼ 148), 13% for sibling allogeneic transplants (n ¼ 110), and 24% (n ¼ 62) for matched unrelated allogeneic transplants, suggesting that our approach is safe. We speculate that more rigorous efforts on the part of transfusion services to provide ABO identical blood components, and to remove incompatible supernatant plasma, when necessary, might yield reduced morbidity and mortality in patients undergoing stem cell transplantation. Bone Marrow Transplantation (2005) 36, 747-755.

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“…In total, 13 RCTs on leukodepleted blood transfusions in different clinical settings evaluated postoperative infections as a primary or secondary endpoint [31][32][33][34][35][36][40][41][42][43][44][45][46]. These studies included singleand multicenter designs, clinical diagnosis, methods for documenting and reporting infections, and the proportion of transfused patients (range: 14%-95%).…”

Section: The Clinical Effects Of Allogeneic Leukocytes In Cardiac Surmentioning

confidence: 99%

“…These studies included singleand multicenter designs, clinical diagnosis, methods for documenting and reporting infections, and the proportion of transfused patients (range: 14%-95%). Among them, 5 included patients undergoing colorectal or gastrointestinal surgery [40][41][42][43][44], 1 was performed with patients undergoing aortic aneurysm repair or resection of gastrointestinal malignancy [45], and 1 included trauma patients [46]. The postoperative infection results in these RCTs, which were conducted with different patient populations using different study designs, are inconsistent.…”

Section: The Clinical Effects Of Allogeneic Leukocytes In Cardiac Surmentioning

confidence: 99%

Allogeneic leukocytes in cardiac surgery: Good or bad?

Bilgin¹,

Brand²

2011

Turk J Hematol

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Worldwide, cardiac surgery is a common procedure requiring a large quantity of allogeneic blood products, which are associated with postoperative complications. Leukocytes present in blood products may play a role in these complications, which are referred to as transfusion-related immunomodulation (TRIM). Several randomized controlled trials (RCTs) in different settings investigated the effects of allogeneic leukocytes in red blood cells (RBCs). Cardiac surgery studies reported a reduction in postoperative infections and mortality in patients that received leukocyte-reduced RBCs compared with leukocyte-containing RBCs; this was mainly due to more deaths due to infections and multiple organ dysfunction syndrome (MODS) in the group that received leukocyte-containing RBCs. Patients with postoperative complications had higher concentrations of inflammatory mediators. These findings suggest that leukocytecontaining transfusion during cardiac surgery induces a second insult to the systemic inflammatory response. In the present review we discuss the possible role of blood transfusions in cardiac surgery. Especially, we focus on the possible role of allogeneic leukocytes associated with postoperative complications after cardiac surgery. (Turk J Hematol 2011; 28: 160-9) Key words: Blood transfusions, transfusion-related immunomodulation, leukodepletion, infections, mortality, cardiac surgery (Turk J Hematol 2011; 28: 160-9) Anahtar kelimeler: Kan transfüzyonları, transfüzyon ile ilişkili immünomodülasyon, lökodeplesyon, enfeksiyonlar, mortalite, kardiyak cerrahisi

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Randomized Trial Comparing Packed Red Cell Blood Transfusion With and Without Leukocyte Depletion for Gastrointestinal Surgery

Cited by 48 publications

References 14 publications

Effects of Blood Products on Nosocomial Infections in Liver Transplant Recipients

Effects of Blood Products on Nosocomial Infections in Liver Transplant Recipients

What would Karl Landsteiner do? The ABO blood group and stem cell transplantation

Allogeneic leukocytes in cardiac surgery: Good or bad?

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