BMJ  2004;328:1281 (29 May), doi:10.1136/bmj.38103.735266.55 (published 13 May 2004)

Paper

Effects of transfusion with red cells filtered to remove leucocytes: randomised controlled trial in patients undergoing major surgery

¹ Department of Immunohaematology and Blood Transfusion, Leiden University Medical Center and Sanquin Blood Supply, PO Box 9600, 2300 RC Leiden, Netherlands, ² Department of Surgery, Leiden University Medical Center, Leiden, ³ Department of Medical Decision Making, Leiden University Medical Center, Leiden, ⁴ Department of Medical Statistics, Leiden University, Leiden, ⁵ Medisch Spectrum Twente, PO Box 50000, 7500 KA Enschede, ⁶ St Joseph Ziekenhuis, P O Box 7777, 5500 MB Veldhoven, ⁷ St Antonius Ziekenhuis, PO Box 2500, 3430 EM Nieuwegein, ⁸ Albert Schweitzer, Locatie Dordwijk, PO Box 306, 3300 AH Dordrecht, ⁹ Reinier de Graaf Groep, PO Box 5011, 2600 GA Delft

Objective To compare postoperative complications in patients undergoing major surgery who received non-filtered or filtered red blood cell transfusions.

Design Prospective, randomised, double blinded trial.

Setting 19 hospitals throughout the Netherlands (three university; 10 clinical; six general).

Participants 1051 evaluable patients: 79 patients with ruptured aneurysm, 412 patients undergoing elective surgery for aneurysm, and 560 undergoing gastrointestinal surgery.

Interventions The non-filtered products had the buffy coat removed and were plasma reduced. The filtered products had the buffy coat removed, were plasma reduced, and filtered before storage to remove leucocytes.

Main outcome measures Mortality and duration of stay in intensive care. Secondary end points were occurrence of multi-organ failure, infections, and length of hospital stay.

Results No significant differences were found in mortality (odds ratio for filtered v non-filtered 0.80, 95% confidence interval 0.53 to 1.21) and in mean stay in intensive care (- 0.4 day, - 1.6 to 0.6 day). In the filtered group the mean length of hospital stay was 2.4 days shorter (- 4.8 to 0.0 day; P = 0.050) and the incidence of multi-organ failure was 30% lower (odds ratio 0.70, 0.49 to 1.00; P = 0.050). There were no differences in rates of infection (0.98, 0.73 to 1.32).

Conclusion The use of filtered transfusions in some types of major surgery may reduce the length of hospital stay and the incidence of postoperative multi-organ failure.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Filtered blood shortens hospital stay
BMJ 2004 328: 0. [Full Text] [PDF]

This article has been cited by other articles:

• Vamvakas, E. C., Blajchman, M. A. (2009). Transfusion-related mortality: the ongoing risks of allogeneic blood transfusion and the available strategies for their prevention. Blood 113: 3406-3417 [Abstract] [Full text]  
• Murphy, G. J., Reeves, B. C., Rogers, C. A., Rizvi, S. I.A., Culliford, L., Angelini, G. D. (2007). Increased Mortality, Postoperative Morbidity, and Cost After Red Blood Cell Transfusion in Patients Having Cardiac Surgery. Circulation 116: 2544-2552 [Abstract] [Full text]  
• Benfield, R., DuBose, J., Demetriades, D. (2007). Prevention and treatment of post-traumatic acute respiratory distress syndrome. Trauma 9: 255-266 [Abstract]  
• Netzer, G., Shah, C. V., Iwashyna, T. J., Lanken, P. N., Finkel, B., Fuchs, B., Guo, W., Christie, J. D. (2007). Association of RBC Transfusion With Mortality in Patients With Acute Lung Injury. Chest 132: 1116-1123 [Abstract] [Full text]  
• (2004). Other articles noted. Evid. Based Med. 9: e5-e5 [Full text]  
• (2004). Leukocyte-Filtered Blood Transfusions. JWatch General 2004: 2-2 [Full text]  

Rapid Responses:

Read all Rapid Responses

Blood maturity may explain transfusion effects

Guy F Nash
bmj.com, 20 May 2004 [Full text]

Comment about quality of scientific papers in the BMJ

A Stephen LAURENCE
bmj.com, 7 Jun 2004 [Full text]

Online poll

Find out more >>