Storage time of transfused blood and disease recurrence after colorectal cancer surgery

Mynster, Tommie; Nielsen, Hans Jørgen

doi:10.1007/bf02235483

Cited by 86 publications

(99 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, Edna and Bjerkeset [6] failed to find any relationship between the time of blood storage and long-term prognosis. On the other hand, Mynster et al [20] showed that buffy-coat-depleted red cells stored for less than 21 day could be an independent risk factor for cancer recurrence, while blood stored more than 21 days had insignificant effect on the risk of recurrence. However, the results of these studies are difficult to compare because of the significant differences in their methodology.…”

Section: Discussionmentioning

confidence: 99%

Impact of Blood Transfusions on Survival and Recurrence in Colorectal Cancer Surgery

et al. 2012

View full text Add to dashboard Cite

The aim of our study was to evaluate the prognostic significance of blood transfusion on recurrence and survival in patients undergoing curative resections for colorectal cancer. Retrospective analysis of prospectively collected data of patients after elective resections for colorectal cancer between January 2001 and December 2009 was undertaken. The main endpoint was overall survival, disease-free survival, and recurrence rate. These data were evaluated in relation to blood transfusion (group A, no blood transfusion; group B, one to two blood transfusions; group C, three and more blood transfusions). A total of 583 patients met the criteria for inclusion in the study. Of these, 132 (22.6 %) patients received blood transfusion in the perioperative period. There were 83 (14.2 %) patients who received one or two blood transfusions and 49 (8.4 %) patients who required three or more transfusions. Patients with three or more transfusions had a significantly worse 5-year overall survival, disease-free survival, and increased incidence of distant recurrences in comparison with the group without transfusion or the group with one or two transfusions. Multivariate analysis showed that the application of three or more blood transfusions is an independent risk factor for overall survival (P 00.001; HR 2.158; 95 % CI 1.370-3.398), disease-free survival (P<0.001; HR 2.514; 95 % CI 1.648-3.836), and the incidence of distant recurrence (P<0.001; HR 2.902; 95 % CI 1.616-5.212). Application of three or more blood transfusions in patients operated for colorectal carcinoma is an adverse prognostic factor. Indications for blood transfusion should be carefully considered not only with regard to the risk of early complications, but also because of the possibility of compromising long-term results.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of Blood Transfusions on Survival and Recurrence in Colorectal Cancer Surgery

et al. 2012

View full text Add to dashboard Cite

show abstract

“…[5][6][7][8][9] Finally, the storage medium could be deleterious by generating superoxides and inflammatory mediators that could result in oxidative damage. [10][11][12][13] Observational studies, [14][15][16][17][18][19][20] although potentially confounded, 21,22 have suggested that these complicated mechanisms, often collectively referred to as "storage lesion," may adversely affect patient-important outcomes including infection, organ failure, hospital stay, and death. [14][15][16][17][18][19][20] Prior evidence on the age of transfused RBCs has been dominated by uncontrolled observational studies that suggest better outcomes with fresher RBCs.…”

Section: Introductionmentioning

confidence: 99%

Transfusion of fresher vs older red blood cells in hospitalized patients: a systematic review and meta-analysis

Alexander

Barty

Fei

et al. 2016

Blood

102

View full text Add to dashboard Cite

The impact of transfusing fresher vs older red blood cells (RBCs) on patientimportant outcomes remains controversial. Two recently published large trials have provided new evidence. We summarized results of randomized trials evaluating the impact of the age of transfused RBCs. We searched MEDLINE, EMBASE, CINAHL, the Cochrane Database for Systematic Reviews, and Cochrane CENTRAL for randomized controlled trials enrolling patients who were transfused fresher vs older RBCs and reported outcomes of death, adverse events, and infection.Independently and in duplicate, reviewers determined eligibility, risk of bias, and abstracted data. We conducted random effects meta-analyses and rated certainty (quality or confidence) of evidence using the GRADE approach.

show abstract

“…Among the different subgroups of infection, only wound infections were more frequent in patients receiving RBCs more than 21 days old 28 The clinical relevance of this change was studied in different patient populations. 6,10,[12][13][14][15][29][30][31] Recently, the effects of RBC storage duration have been evaluated in patients undergoing cardiac surgery and the rate of postoperative infections ranged from 4% to 15%. 10,12,29 In one study, Koch and colleagues 10 found that in patients receiving RBC transfusions during cardiac surgery, those treated with fresh blood (stored for 14 days) had a reduced occurrence of sepsis (2.8% vs. 4.0%, p 5 0.01) and renal failure (1.6% vs. 2.7%, p 5 0.003) than those receiving old blood, although differences in the baseline characteristics between the two groups could affect the ability to interpret the results.…”

Section: Subgroup Analysismentioning

confidence: 99%

“…30 Nevertheless, the same authors showed in a second study that infection rates were similar in patients transfused with old blood (stored > 21 days) and fresh blood (stored for < 21 days; 34% vs. 29%). 31 However, the influence of old blood transfusion on outcomes of patients undergoing …”

mentioning

confidence: 99%

The effects of storage of red blood cells on the development of postoperative infections after noncardiac surgery

et al. 2017

View full text Add to dashboard Cite

BACKGROUND: Prolonged storage of red blood cells (RBCs) is a potential risk factor for postoperative infections. The objective of this study was to examine the effect of age of RBCs transfused on development of postoperative infection. STUDY DESIGN AND METHODS: In thisprospective, double-blind randomized trial, 199 patients undergoing elective noncardiac surgery and requiring RBC transfusion were assigned to receive nonleukoreduced RBCs stored for not more than 14 days ("fresh blood" group, n 5 101) or for more than 14 days ("old blood" group, n 5 98). The primary outcome was occurrence of infection within 28 days after surgery; secondary outcomes were postoperative acute kidney injury (AKI), in-hospital and 90-day mortality, admission to intensive care unit, and hospital length of stay (LOS). As older blood was not always available, an "as-treated" (AT) analysis was also performed according to actual age of the RBCs transfused. RESULTS:The median [interquartile range] storage time of and 15 [11][12][13][14][15][16][17][18][19][20] days in fresh blood and in old blood groups, respectively. The occurrence of postoperative infection did not differ between groups (fresh blood 22% vs. old blood 25%; relative risk [RR], 1.17; confidence interval [CI], 0.71-1.93), although wound infections occurred more frequently in old blood (15% vs. 5%; RR, 3.09; CI,). Patients receiving older units had a higher rate of AKI (24% vs. 6%; p < 0.001) and, according to AT analysis, longer LOS (mean difference, 3.6 days; CI, 0.6-7.5).CONCLUSION: Prolonged RBC storage time did not increase the risk of postoperative infection. However, old blood transfusion increased wound infections rate and incidence of AKI. Immunosuppression induced by surgery and anesthesia may be aggravated by transfusion. 9 Most studies in trauma and cardiac surgery reported that prolonged RBC storage was a risk factor for postoperative infections after cardiac surgery, 10-12 but the same association was not found in liver transplantation 13 or orthopedic surgery. 14 A recent systematic review 15 that analyzed four trials which investigated the nosocomial infections, showed no benefits in receiving fresh RBCs. However, the authors reported that the results are difficult to interpret because the studies involved different populations and there were considerable differences in the length of storage of fresh and old blood and in study methods. 15To our knowledge, the association of age of RBCs with infections in noncardiac surgery population has not been investigated by double-blind randomized studies. Accordingly, the aim of this study was to investigate the relationship between RBC storage time and postoperative infection after elective noncardiac surgery. In addition, we evaluated the effects of the age of RBCs on other outcomes such as postoperative acute kidney injury (AKI), hospital length of stay (LOS), and 90-day mortality. MATERIALS AND METHODS Study populationThis prospective, randomized, controlled, double-blind clinical trial was conducted between August 2...

show abstract

Storage time of transfused blood and disease recurrence after colorectal cancer surgery

Abstract: Transfusion of buffy-coat-depleted red cells suspended in saline, adenine, glucose, and mannitol blood stored for < 21 days may be an independent risk factor for development of recurrence after elective colorectal cancer surgery.

Cited by 86 publications

References 32 publications

Impact of Blood Transfusions on Survival and Recurrence in Colorectal Cancer Surgery

Impact of Blood Transfusions on Survival and Recurrence in Colorectal Cancer Surgery

Transfusion of fresher vs older red blood cells in hospitalized patients: a systematic review and meta-analysis

The effects of storage of red blood cells on the development of postoperative infections after noncardiac surgery

Contact Info

Product

Resources

About