Spanish consensus statement on alternatives to allogeneic transfusions: the ‘Seville document’

Abstract

SUMMARY The Consensus Document on Alternatives to Allogeneic Blood Transfusion (AABT) has been drawn up by a panel of experts from five scientific societies. The Spanish societies of anesthesiology (SEDAR), critical care medicine and coronary units (SEMICYUC), hematology and hemotherapy (AEHH), blood transfusion (SETS), and thrombosis and hemostasis (SETH) have sponsored and participated in this consensus document. Alternatives to blood transfusion have been divided into pharmacological and nonpharmacological, with four modules and 12 topics. The main objective variable was the reduction of allogeneic blood transfusions and/or the number of transfused patients. The extent to which this objective was achieved by each AABT was evaluated using the Delphi methodology, which classifies the grades of recommendation from ‘A’ (supported by controlled studies) to ‘E’ (noncontrolled studies and expert opinion). The experts concluded that most of the indications for AABT only attained middle or low grades of recommendation, ‘C’, ‘D’ or ‘E’, thus indicating the need for further controlled studies.

Is Allogeneic Blood Transfusion a Risk Factor for Sternal Dehiscence Following Cardiac Surgery? A Prospective Observational Study

“…The restrictive approach to allogeneic blood transfusion should always be adhered to, 19) and the guidelines for alternatives to blood transfusion should be followed. [14][15][16]19) The operation should also be avoided in anemic patients. 18,20) Our study was designed to evaluate the role of allogeneic blood transfusion in sternal wound dehiscence following median sternotomy in patients who underwent cardiac surgery.…”

Factors affecting outcome of allogeneic stem cell transplantation as salvage in patients with acute myeloid leukemia primary refractory to intensive induction therapy

“…For adults, transplantation using two cord units is frequently necessary [3][4][5] and literature demonstrates that double umbilical cord blood transplantation (DUCT) yields durable remissions [1,5,6]. Data on DUCT in hepatosplenic gamma-delta T-cell lymphoma with hemophagocytic lymphohistiocytosis (HLH) are limited to case reports [7,8].…”

“…In an amalgam of published evidence (see Fig. 1, presented by Shander at the 2014 Annual Meeting of the European Society of Anaesthesiology) the use of allogeneic red blood cell transfusion provides the lowest benefit, highest risk, and sadly, has the highest use The Spanish consensus statement recommends routine, proactive diagnostic, and interventional anemia management [5].…”

Seguridad y eficacia de un concentrado de complejo protrombínico en pacientes con coagulopatía y hemorragia

“…El uso de los CCP está aumentando fuera de indicación clínica en el manejo de la coagulopatía de la hemorragia grave 3,4 . Se ha demostrado beneficio del uso de CCP en sangrado masivo, en comparación con otras estrategias que involucran el uso de hemoderivados y otros agentes prohemostáticos, como el factor VIIa recombinante 5 . El objetivo del presente trabajo es analizar la experiencia de un centro en el uso de un CCP de segunda generación (octaplex ®), con respecto a la seguridad y eficacia, tanto en su indicación aprobada, como fuera de ficha técnica para el manejo complementario de la hemorragia masiva.…”