Abstract
Allogenic blood transfusions (ABTs) are widely used in the perioperative care of patients undergoing major surgery. According to the last available update of the World Health Organization Global Database on Blood Safety, approximately 92 million blood donations are collected annually worldwide, with surgical procedures accounting for consumption of up to 40 % of total blood supply in Western countries.
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References
WHO (2011) Global database on blood safety. Summary report
Murphy GJ, Pike K, Rogers CA et al (2015) Liberal or restrictive transfusion after cardiac surgery. N Engl J Med 372:997–1008
de Almeida JP, Vincent JL, Galas FR et al (2015) Transfusion requirements in surgical oncology patients: a prospective, randomized controlled trial. Anesthesiology 122:29–38
Gregersen M, Borris LC, Damsgaard EM (2015) Postoperative blood transfusion strategy in frail, anemic elderly patients with hip fracture. Acta Orthop 86:363–372
Holst LB, Petersen MW, Haasen N et al (2015) Restrictive versus liberal transfusion strategy for red blood cell transfusion: systematic review of randomised trial with meta-analysis and trial sequential analysis. BMJ 350:h1354
Fominskiy E, Putzu E, Monaco F et al (2015) Liberal transfusion strategy improves survival in perioperative patients. A meta-analysis of randomised trials. BJA 115(4):511–519
Carson JL, Brooks MM, Abbott JD et al (2013) Liberal versus restrictive transfusion thresholds for patients with symptomatic coronary artery disease. Am Heart J 165:964–971
Vamvakas EC, Blaychman MA (2009) Transfusion-related mortality: the ongoing risk of allogeneic blood transfusion and the available strategies for their prevention. Blood 113:3406–3417
Bilgin YM, van de Watering LMG, Brand A (2011) Clinical effects of leucoreduction of blood transfusions. Neth J Med 69:441–450
Vamvakas EC, Blajchmann MA (2001) Deleterious clinical effects of transfusion-associated immunomodulation: fact or fiction? Blood 97:1180–1195
Van de Watering LMG, Hermans J, Houbiers JGA et al (1998) Beneficial effects of leukocyte depletion of transfused blood on postoperative complications in patients undergoing cardiac surgery: a randomized clinical trial. Circulation 97:562–568
Bilgin YM, van de Watering LMG, Eijsman L (2004) Double-blind, randomized controlled trial on the effect of leukocyte-depleted erythrocyte transfusion in cardiac valve surgery. Circulation 109:2755–2760
Connery CP, Toumpoulis IK, Anagnostopoulis CE (2005) Does leukofiltration reduce pulmonary infections in CABG patients? A prospective, randomised study with early results and mid-term survival. Acta Cardiol 60:285–293
Wallis JP, Chapman CE, Orr KE et al (2002) Effect of WBC reduction of transfused RBCs on postoperative infection rates in cardiac surgery. Transfusion 42:1127–1134
Bracey AW, Radovancevick R, Nussimeier NA et al (2002) Leukocyte-reduced blood in open-heart surgery patients: effect on outcome. Transfusion 42:5S
Boshkov LK, Furnary A, Morris C et al (2004) Prestorage leukoreduction of red cells in elective cardiac surgery: results of a double-blind randomized controlled trial. Blood 104:112a
Bilgin YM, van de Watering LMG, Eijsman L (2007) Is increased mortality associated with post-operative infections after leukocytes containing red blood cell transfusions in cardiac surgery? An extended analysis. Transfus Med 17:304–311
Vamvakas EC (2007) White-blood-cell-containing allogenic blood transfusion and postoperative infection or mortality: an update meta-analysis. Vox Sang 92:224–232
Jensen LS, Kissmeyer-Nielsen P, Wolff B et al (1996) Randomised comparison of leucocytedepleted versus buffy-coat-poor blood transfusion and complications after colorectal surgery. Lancet 348:841–845
Titlestad IL, Ebbesen LS, Ainsworth AP (2001) Leukocyte-depletion of blood components does not significantly reduce the risk of infections complications: results of a double-blinded, randomized study. Int J Colorectal Dis 16:147–153
Skanberg J, Lundholm K, Haglind E (2007) Effects of blood transfusion with leucocyte depletion on length of hospital stay, respiratory assistance and survival after curative surgery for colorectal cancer. Acta Oncol 46:1123–1130
Dzik WH, Anderson JK, O’Neill EM (2002) A prospective, randomized clinical trial of universal WBC reduction. Transfusion 42:1114–1122
Van Hilten JA, van de Watering LMG, van Bockel JH (2004) Effects of transfusion with red cells filtered to remove leukocytes: randomized controlled trial in patients undergoing major surgery. BMJ 328:1281–1284
Nielsen HJ, Hammer J, Kraup AL (1999) Prestorage leukocyte filtration may reduce leukocyte-derived bioactive substance accumulation in patients operated for burn trauma. Burns 25:162–170
Landoni G, Rodseth RN, Santini F (2012) Randomized evidence for reduction of perioperative mortality. J Cardiothorac Vasc Anesth 26:764–772
Landoni G, Pisano A, Lomivorotov V et al (2016) Randomized evidence for reduction of perioperative mortality: an updated consensus process. J Cardiothorac Vasc Anesth. doi: 10.1053/j.jvca.2016.07.017
McQuilten ZK, Andrianopoulos N, van de Watering L et al (2015) Introduction of universal prestorage leukodepletion of blood components and outcomes in transfused cardiac surgery patients. J Thorac Cardiovasc Surg 150:216–222
Fergusson D, Khanna MP, Tinmouth A (2004) Transfusion of leukoreduced red blood cells may decrease postoperative infections: two meta-analyses of randomized controlled trials. Can J Anaesth 51:417–424
Vamvakas EC (2007) Why have meta-analyses of randomized controlled trials of the association between non-white-blood-cell-reduced allogenic blood transfusion and postoperative infection produced discordant results? Vox Sang 93:196–207
Blumberg N, Zhao H, Wang H (2007) The intention-to-treat principle in clinical trials and meta-analyses of leukoreduced blood transfusions in surgical patients. Transfusion 4:573–581
Bilgin JM, van de Watering LMG, Versteegh MIM (2010) Effects of allogeneic leukocytes in blood transfusions during cardiac surgery on inflammatory mediators and postoperative complications. Crit Care Med 38:546–552
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Summary Table
Clinical summary | |||||
|---|---|---|---|---|---|
Technique | Indications | Cautions | Side effects | Dose | Notes |
Leukodepletion of transfused RBC by (pre- and post-storage) filtration | Cardiac surgery | None | Generally well tolerated “Red eyes” syndrome High costs | Prestorage filtration, within 2–4 h after collection, is preferred It allows to obtain a WBC count of 1–5 × 106 per unit | Mortality reduction may be related to reduction in both TRIM and infection rate Allogenic leukocytes result in a pro-inflammatory effect that worsen SIRS triggered by CPB in cardiac surgery |
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Capasso, A., Masserini, F., Pisano, A. (2017). Leukocyte Depletion of Transfused Blood May Reduce Mortality in Cardiac Surgery Patients. In: Landoni, G., Ruggeri, L., Zangrillo, A. (eds) Reducing Mortality in the Perioperative Period. Springer, Cham. https://doi.org/10.1007/978-3-319-46696-5_9
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DOI: https://doi.org/10.1007/978-3-319-46696-5_9
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