Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/12777
Title: Introduction of universal prestorage leukodepletion of blood components, and outcomes in transfused cardiac surgery patients.
Authors: McQuilten, Zoe K;Andrianopoulos, Nick;van de Watering, Leo;Aubron, Cecile;Phillips, Louise;Bellomo, Rinaldo;Pilcher, David V;Cameron, Peter A;Reid, Christopher M;Cole-Sinclair, Merrole F;Newcomb, Andrew;Smith, Julian A;McNeil, John J;Wood, Erica M
Affiliation: Department of Epidemiology and Preventive Medicine, Transfusion Research Unit, Monash University, Melbourne, Victoria, Australia; Department of Epidemiology and Preventive Medicine, The Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Monash University, Melbourne, Victoria, Australia; Research and Development, Australian Red Cross Blood Service, Melbourne, Victoria, Australia; Department of Haematology, St Vincent's Hospital, Melbourne, Victoria, Australia. Electronic address: zoe.mcquilten@monash.edu.
Sanquin-LUMC (Leiden University Medical Centre), Center for Clinical Transfusion Research, Leiden, The Netherlands.
Department of Epidemiology and Preventive Medicine, The Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Monash University, Melbourne, Victoria, Australia.
Department of Epidemiology and Preventive Medicine, The Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Monash University, Melbourne, Victoria, Australia; Intensive Care Unit, Austin Hospital, Melbourne, Victoria, Australia.
Department of Epidemiology and Preventive Medicine, The Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Monash University, Melbourne, Victoria, Australia; Intensive Care Unit, Alfred Hospital, Melbourne, Victoria, Australia.
Department of Epidemiology and Preventive Medicine, Transfusion Research Unit, Monash University, Melbourne, Victoria, Australia.
Research and Development, Australian Red Cross Blood Service, Melbourne, Victoria, Australia.
University of Melbourne Department of Surgery (Cardiothoracic Surgery), St Vincent's Hospital, Melbourne, Victoria, Australia.
Department of Surgery, Monash Medical Centre, Monash University, Melbourne, Victoria, Australia; Department of Cardiothoracic Surgery, Monash Medical Centre, Melbourne, Victoria, Australia.
Issue Date: 14-Mar-2015
Citation: The Journal of Thoracic and Cardiovascular Surgery 2015; 150(1): 216-22
Abstract: To assess whether introduction of universal leukodepletion (ULD) of red blood cells (RBCs) for transfusion was associated with improvements in cardiac surgery patient outcomes.Retrospective study (2005-2010) conducted at 6 institutions. Associations between leukodepletion and outcomes of mortality, infection, and acute kidney injury (AKI) were modeled by logistic regression, and intensive care unit length of stay (LOS) in survivors was explored using linear regression. To examine trends over time, odds ratios (ORs) for outcomes of transfused were compared with nontransfused patients, including a comparison with nontransfused patients who were selected based on propensity score for RBC transfusion.We studied 14,980 patients, of whom 8857 (59%) had surgery pre-ULD. Transfusions of RBCs were made in 3799 (43%) pre-ULD, and 2525 (41%) post-ULD. Administration of exclusively leukodepleted, versus exclusively nonleukodepleted, RBCs was associated with lower incidence of AKI (adjusted OR 0.80, 95% confidence interval [CI] 0.65-0.98, P = .035), but no difference in mortality or infection. For post-ULD patients, no difference was found in mortality (OR 0.96, 95% CI 0.76-1.22, P = .76) or infection (OR 0.91, 95% CI 0.79-1.03, P = .161); however, AKI was reduced (OR 0.79 95% CI 0.68-0.92, P = .003). However, ORs for post-ULD outcomes were not significantly different in nontransfused, versus transfused, patients. Furthermore, those who received exclusively nonleukodepleted RBCs were more likely to have surgery post-ULD.Universal leukodepletion was not associated with reduced mortality or infection in transfused cardiac surgery patients. An association was found between ULD and reduced AKI; however, this reduction was not significantly different from that seen in nontransfused patients, and other changes in care most likely explain such changes in renal outcomes.
Internal ID Number: 25940409
URI: http://ahro.austin.org.au/austinjspui/handle/1/12777
DOI: 10.1016/j.jtcvs.2015.03.015
URL: http://www.ncbi.nlm.nih.gov/pubmed/25940409
Type: Journal Article
Subjects: Leukocyte reduction procedures
coronary artery bypass
erythrocyte transfusion
Appears in Collections:Journal articles

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