Transfusion of sex-mismatched and non-leukocyte-depleted red blood cells in cardiac surgery increases mortality.
(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:
https://lup.lub.lu.se/record/8825554
- author
- Bjursten, Henrik LU ; Dardashti, Alain LU ; Björk, Jonas LU ; Wierup, Per LU ; Algotsson, Lars LU and Ederoth, Per LU
- organization
- publishing date
- 2015-12-19
- type
- Contribution to journal
- publication status
- published
- subject
- in
- The Journal of thoracic and cardiovascular surgery
- publisher
- Mosby-Elsevier
- external identifiers
-
- pmid:26874600
- scopus:84957927032
- pmid:26874600
- wos:000378858800068
- 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
- 2016-04-01 13:18:30
- date last changed
- 2022-03-29 06:46:32
@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-Elsevier}}, 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}}, doi = {{10.1016/j.jtcvs.2015.12.022}}, year = {{2015}}, }