Real world reduction in red cell transfusion with restrictive transfusion threshold in haematology inpatients

Abstract

Objectives The aim of this study was to assess the reduction in red cell transfusions following a change in the red cell transfusion threshold for haematology inpatients from 80 to 70 g/L. Background Haematology patients are among the high users of red blood cells. We reduced the threshold for transfusion of haematology inpatients to 70 g/L. This was based on evidence provided by randomised controlled trial published in 2020 that showed restrictive transfusion is non‐inferior to liberal transfusion. Method We assessed red cell transfusions for haematology inpatients at Oxford University Hospitals NHS Foundation Trust for 9 months before and 9 months after a change in red cell transfusion threshold from 80 to 70 g/L. Results After the change in threshold to 70 g/L or less from 80 g/L, the median number of red cell transfusions per month reduced to 88 from 111. This was a 23% reduction in the total number of red cells administered per month. Conclusion These results show the real‐world reductions in transfusion that can be made by putting local transfusion guidelines in line with the international recommendations. This is of particular importance at a time of national blood shortage.

Consensus of the Brazilian association of hematology, hemotherapy and cellular therapy on patient blood management

“…In recent years, there has been increasing recognition that more restrictive transfusion thresholds may be not only safe but also beneficial in specific clinical situations. 11 , 12 , 13 , 14 , 15 , 16 , 17 …”