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Transfusion of sex-mismatched and non-leukocyte-depleted red blood cells in cardiac surgery increases mortality.

Bjursten, Henrik LU ; Dardashti, Alain LU ; Björk, Jonas LU ; Wierup, Per LU ; Algotsson, Lars LU and Ederoth, Per LU (2015) In The Journal of thoracic and cardiovascular surgery
Abstract
OBJECTIVE:



To examine the mortality risk of blood transfusions when donor information, postdonation treatment, and a wide selection of risk factors are taken into account.

METHODS:



A retrospective study was performed on 9907 patients who underwent coronary artery bypass grafting and/or aortic valve replacement. Several transfusion-related risk factors, including age of blood products, sex of donor, ABO group, Rh group, posttransfusion treatment, and sex matching, were included in the analysis. A wide selection of preoperative comorbidities were included as well. A Cox proportional hazards analysis was performed to determine significant risk factors. Patients were followed for a period of up to... (More)
OBJECTIVE:



To examine the mortality risk of blood transfusions when donor information, postdonation treatment, and a wide selection of risk factors are taken into account.

METHODS:



A retrospective study was performed on 9907 patients who underwent coronary artery bypass grafting and/or aortic valve replacement. Several transfusion-related risk factors, including age of blood products, sex of donor, ABO group, Rh group, posttransfusion treatment, and sex matching, were included in the analysis. A wide selection of preoperative comorbidities were included as well. A Cox proportional hazards analysis was performed to determine significant risk factors. Patients were followed for a period of up to 12 years posttransfusion.

RESULTS:



We found an excess mortality for transfusions of sex-mismatched red blood cells (RBCs) per unit transfused (hazard ratio [HR], 1.083; 95% confidence interval [CI] 1.028-1.140; P = .003). In addition, we found a significant risk during the first year for transfusing 1 to 2 units of non-leukocyte-depleted RBCs (HR, 1.426; 95% CI, 1.004-2.024; P = .047). Transfusion of 1 to 2 units of leukocyte-depleted RBCs was not associated with increased risk (HR, 0.981; 95% CI, 0.866-1.110; P = not significant). The age of blood products was not associated with increased mortality.

CONCLUSIONS:



In this large retrospective study, transfusion of non-sex-matched RBCs was associated with increased mortality. In addition, in patients receiving small amounts of blood, leukocyte depletion of RBCs had a beneficial effect on patient survival. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
The Journal of thoracic and cardiovascular surgery
publisher
Mosby
external identifiers
  • pmid:26874600
  • scopus:84957927032
ISSN
1097-685X
DOI
10.1016/j.jtcvs.2015.12.022
language
English
LU publication?
yes
id
8689d4f5-7df7-481c-8a16-25a15841b237 (old id 8825554)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/26874600?dopt=Abstract
date added to LUP
2016-03-04 11:05:47
date last changed
2017-11-19 03:44:55
@article{8689d4f5-7df7-481c-8a16-25a15841b237,
  abstract     = {OBJECTIVE:<br/><br>
<br/><br>
To examine the mortality risk of blood transfusions when donor information, postdonation treatment, and a wide selection of risk factors are taken into account.<br/><br>
METHODS:<br/><br>
<br/><br>
A retrospective study was performed on 9907 patients who underwent coronary artery bypass grafting and/or aortic valve replacement. Several transfusion-related risk factors, including age of blood products, sex of donor, ABO group, Rh group, posttransfusion treatment, and sex matching, were included in the analysis. A wide selection of preoperative comorbidities were included as well. A Cox proportional hazards analysis was performed to determine significant risk factors. Patients were followed for a period of up to 12 years posttransfusion.<br/><br>
RESULTS:<br/><br>
<br/><br>
We found an excess mortality for transfusions of sex-mismatched red blood cells (RBCs) per unit transfused (hazard ratio [HR], 1.083; 95% confidence interval [CI] 1.028-1.140; P = .003). In addition, we found a significant risk during the first year for transfusing 1 to 2 units of non-leukocyte-depleted RBCs (HR, 1.426; 95% CI, 1.004-2.024; P = .047). Transfusion of 1 to 2 units of leukocyte-depleted RBCs was not associated with increased risk (HR, 0.981; 95% CI, 0.866-1.110; P = not significant). The age of blood products was not associated with increased mortality.<br/><br>
CONCLUSIONS:<br/><br>
<br/><br>
In this large retrospective study, transfusion of non-sex-matched RBCs was associated with increased mortality. In addition, in patients receiving small amounts of blood, leukocyte depletion of RBCs had a beneficial effect on patient survival.},
  author       = {Bjursten, Henrik and Dardashti, Alain and Björk, Jonas and Wierup, Per and Algotsson, Lars and Ederoth, Per},
  issn         = {1097-685X},
  language     = {eng},
  month        = {12},
  publisher    = {Mosby},
  series       = {The Journal of thoracic and cardiovascular surgery},
  title        = {Transfusion of sex-mismatched and non-leukocyte-depleted red blood cells in cardiac surgery increases mortality.},
  url          = {http://dx.doi.org/10.1016/j.jtcvs.2015.12.022},
  year         = {2015},
}