Document Detail


Beneficial effects of leukocyte depletion of transfused blood on postoperative complications in patients undergoing cardiac surgery: a randomized clinical trial.
MedLine Citation:
PMID:  9494026     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Leukocytes in transfused blood are associated with several posttransfusion immunomodulatory effects. Although leukocytes play an important role in reperfusion injury, the contribution of leukocytes in transfused blood products has not been investigated. To estimate the role and the timing of leukocyte filtration of red cells in cardiac surgery, we performed a randomized study. METHODS AND RESULTS: Patients scheduled for cardiac surgery were randomly allocated to receive either packed cells without buffy coat (PC, n = 306), fresh-filtered units (FF, n = 305), or stored-filtered units (SF, n = 303) when transfusion was indicated. We evaluated the periods of hospitalization and stay at the intensive care unit, and the occurrences of postoperative complications up to 60 days after surgery. The average hospital stay was 10.7 days, of which 3.2 days were in the intensive care unit, without significant differences between the groups. In the PC trial arm, 23.0% of the patients had infections versus 16.9% and 17.9% of the patients in the leukocyte-depleted trial arms (P=.13). Within 60 days, 45 patients had died, 24 patients in the PC trial arm (7.8%), versus 11 (3.6%) and 10 (3.3%) patients in the FF and SF trial arms, respectively (P=.015). CONCLUSIONS: In cardiac surgery patients, especially when more than three blood transfusions are required, leukocyte depletion by filtration results in a significant reduction of the postoperative mortality that can only partially be explained by the higher incidence of postoperative infections in the PC group.
Authors:
L M van de Watering; J Hermans; J G Houbiers; P J van den Broek; H Bouter; F Boer; M S Harvey; H A Huysmans; A Brand
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  97     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1998 Feb 
Date Detail:
Created Date:  1998-03-10     Completed Date:  1998-03-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  562-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Immunohematology and Blood Bank, Leiden University Medical Centre, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Antibody Formation
Bacterial Infections / mortality
Blood Transfusion / methods*
Cardiac Surgical Procedures*
Female
Filtration*
HLA Antigens / immunology
Humans
Length of Stay
Leukocytes
Male
Middle Aged
Postoperative Complications / mortality*
Risk Factors
Statistics as Topic
Chemical
Reg. No./Substance:
0/HLA Antigens

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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