Transfusion of fresher vs older red blood cells in hospitalized patients: a systematic review and meta-analysis

Blood - Tập 127 - Trang 400-410 - 2016
Paul E. Alexander1, Rebecca Barty2, Yutong Fei1,3, Per Olav Vandvik4,5,6, Menaka Pai7,8, Reed A.C. Siemieniuk9, Nancy M. Heddle7, Neil Blumberg10, Shelley L. McLeod11, Jianping Liu3, John W. Eikelboom7, Gordon H. Guyatt1
1Health Research Methods (HRM), Health Sciences Building (HSB), Department of Clinical Epidemiology and Biostatistics, McMaster University, West Hamilton, ON, Canada
2McMaster Transfusion Research Program, McMaster University, Faculty of Health Sciences, Department of Medicine, Hamilton, ON, Canada;
3Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
4Faculty of Medicine, University of Oslo, Norway
5Norwegian Knowledge Centre for the Health Services, Oslo, Norway
6Department of Medicine, Innlandet Hospital Trust-division, Gjøvik, Norway
7Department of Medicine, McMaster University Thrombosis and Atherosclerosis Research Institute (TaARI), McMaster University, West Hamilton, ON, Canada;
8Department of Pathology and Molecular Medicine, McMaster University Thrombosis and Atherosclerosis Research Institute (TaARI), McMaster University, West Hamilton, ON, Canada;
9Department of Medicine, University of Toronto, Toronto, ON, Canada
10Clinical Laboratories, University of Rochester Medical Center, Rochester, NY
11Schwartz/Reisman Emergency Medicine Institute, Department of Family and Community Medicine University of Toronto, Toronto, ON, Canada

Tóm tắt

Abstract The impact of transfusing fresher vs older red blood cells (RBCs) on patient-important outcomes remains controversial. Two recently published large trials have provided new evidence. We summarized results of randomized trials evaluating the impact of the age of transfused RBCs. We searched MEDLINE, EMBASE, CINAHL, the Cochrane Database for Systematic Reviews, and Cochrane CENTRAL for randomized controlled trials enrolling patients who were transfused fresher vs older RBCs and reported outcomes of death, adverse events, and infection. Independently and in duplicate, reviewers determined eligibility, risk of bias, and abstracted data. We conducted random effects meta-analyses and rated certainty (quality or confidence) of evidence using the GRADE approach. Of 12 trials that enrolled 5229 participants, 6 compared fresher RBCs with older RBCs and 6 compared fresher RBCs with current standard practice. There was little or no impact of fresher vs older RBCs on mortality (relative risk [RR], 1.04; 95% confidence interval [CI], 0.94-1.14; P = .45; I2 = 0%, moderate certainty evidence) or on adverse events (RR, 1.02; 95% CI, 0.91-1.14; P = .74; I2 = 0%, low certainty evidence). Fresher RBCs appeared to increase the risk of nosocomial infection (RR, 1.09; 95% CI, 1.00-1.18; P = .04; I2 = 0%, risk difference 4.3%, low certainty evidence). Current evidence provides moderate certainty that use of fresher RBCs does not influence mortality, and low certainty that it does not influence adverse events but could possibly increase infection rates. The existing evidence provides no support for changing practices toward fresher RBC transfusion.

Tài liệu tham khảo

Holst, 2014, Lower versus higher hemoglobin threshold for transfusion in septic shock., N Engl J Med, 371, 1381, 10.1056/NEJMoa1406617 Lacroix, 2007, Transfusion strategies for patients in pediatric intensive care units., N Engl J Med, 356, 1609, 10.1056/NEJMoa066240 Holst, 2015, Restrictive versus liberal transfusion strategy for red blood cell transfusion: systematic review of randomised trials with meta-analysis and trial sequential analysis., BMJ, 350, h1354, 10.1136/bmj.h1354 Brunskill, 2015, Red blood cell transfusion for people undergoing hip fracture surgery., Cochrane Database Syst Rev, 4, CD009699 Qu, 2015, Clinical effects of red blood cell storage., Cancer Control, 22, 26, 10.1177/107327481502200105 Sparrow, 2015, Red blood cell storage duration and trauma., Transfus Med Rev, 29, 120, 10.1016/j.tmrv.2014.09.007 Hod, 2011, Harmful effects of transfusion of older stored red blood cells: iron and inflammation., Transfusion, 51, 881, 10.1111/j.1537-2995.2011.03096.x Wang, 2014, Transfusion of older stored blood worsens outcomes in canines depending on the presence and severity of pneumonia., Transfusion, 54, 1712, 10.1111/trf.12607 Grimshaw, 2011, New frontiers in transfusion biology: identification and significance of mediators of morbidity and mortality in stored red blood cells., Transfusion, 51, 874, 10.1111/j.1537-2995.2011.03095.x Khan, 2006, Soluble CD40 ligand accumulates in stored blood components, primes neutrophils through CD40, and is a potential cofactor in the development of transfusion-related acute lung injury., Blood, 108, 2455, 10.1182/blood-2006-04-017251 Bercovitz, 2012, The pro-inflammatory effects of platelet contamination in plasma and mitigation strategies for avoidance., Vox Sang, 102, 345, 10.1111/j.1423-0410.2011.01559.x Kücükakin, 2011, Storage-induced increase in biomarkers of oxidative stress and inflammation in red blood cell components., Scand J Clin Lab Invest, 71, 299, 10.3109/00365513.2011.563789 Ogunro, 2010, The influence of storage period on the antioxidants level of red blood cells and the plasma before transfusion., Afr J Med Med Sci, 39, 99 Vamvakas, 1999, Transfusion and postoperative pneumonia in coronary artery bypass graft surgery: effect of the length of storage of transfused red cells., Transfusion, 39, 701, 10.1046/j.1537-2995.1999.39070701.x Mynster, 2001, Storage time of transfused blood and disease recurrence after colorectal cancer surgery., Dis Colon Rectum, 44, 955, 10.1007/BF02235483 Leal-Noval, 2003, Influence of erythrocyte concentrate storage time on postsurgical morbidity in cardiac surgery patients., Anesthesiology, 98, 815, 10.1097/00000542-200304000-00005 Mynster, 2000, The impact of storage time of transfused blood on postoperative infectious complications in rectal cancer surgery. Danish RANX05 Colorectal Cancer Study Group., Scand J Gastroenterol, 35, 212, 10.1080/003655200750024416 Lee, 2015, Effect of intraoperative red blood cell transfusion on postoperative complications after open radical cystectomy: old versus fresh stored blood., Clin Genitourin Cancer, 13, 581, 10.1016/j.clgc.2015.06.002 Koch, 2008, Duration of red-cell storage and complications after cardiac surgery., N Engl J Med, 358, 1229, 10.1056/NEJMoa070403 Manlhiot, 2012, Longer blood storage is associated with suboptimal outcomes in high-risk pediatric cardiac surgery., Ann Thorac Surg, 93, 1563, 10.1016/j.athoracsur.2011.08.075 Steiner, 2009, Does red blood cell storage affect clinical outcome? When in doubt, do the experiment., Transfusion, 49, 1286, 10.1111/j.1537-2995.2009.02265.x Vamvakas, 2010, Meta-analysis of clinical studies of the purported deleterious effects of “old” (versus “fresh”) red blood cells: are we at equipoise?, Transfusion, 50, 600, 10.1111/j.1537-2995.2009.02465.x Wang, 2012, Transfusion of older stored blood and risk of death: a meta-analysis., Transfusion, 52, 1184, 10.1111/j.1537-2995.2011.03466.x Middelburg, 2013, Storage time of red blood cells and mortality of transfusion recipients., Transfus Med Rev, 27, 36, 10.1016/j.tmrv.2012.06.002 Brunskill, 2015, Transfusion of fresher versus older red blood cells for all conditions., Cochrane Database Syst Rev, 5, CD010801 Steiner, 2015, Effects of red-cell storage duration on patients undergoing cardiac surgery., N Engl J Med, 372, 1419, 10.1056/NEJMoa1414219 Lacroix, 2015, Age of transfused blood in critically ill adults., N Engl J Med, 372, 1410, 10.1056/NEJMoa1500704 Cochrane Bias Methods Group Assessing Risk of Bias in Included Studies. Available at: http://bmg.cochrane.org/assessing-risk-bias-included-studies. Accessed on July 15, 2015 Guyatt G Busse J Methods Commentary: Risk of Bias in Randomized Trials 1.Available at: http://distillercer.com/resources/methodological-resources/risk-of-bias-commentary/. Accessed on January 31, 2015 Guyatt, 2011, GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables., J Clin Epidemiol, 64, 383, 10.1016/j.jclinepi.2010.04.026 Andrews, 2013, GRADE guidelines 15: going from evidence to recommendation-determinants of a recommendation's directionand strength., J Clin Epidemiol, 66, 726, 10.1016/j.jclinepi.2013.02.003 Landis, 1977, The measurement of observer agreement for categorical data., Biometrics, 33, 159, 10.2307/2529310 RevMan 5. url: http://tech.cochrane.org/revman/download. Accessed on June 2, 2015 Langan, 2015, An empirical comparison of heterogeneity variance estimators in 12 894 meta-analyses., Res Synth Methods, 6, 195, 10.1002/jrsm.1140 Akl, 2012, Potential impact on estimated treatment effects of information lost to follow-up in randomised controlled trials (LOST-IT): systematic review., BMJ, 344, e2809, 10.1136/bmj.e2809 Neuman, 2015, Effects of storage-aged red blood cell transfusions on endothelial function in hospitalized patients., Transfusion, 55, 782 Bennett-Guerrero, 2009, A prospective, double-blind, randomized clinical feasibility trial of controlling the storage age of red blood cells for transfusion in cardiac surgical patients., Transfusion, 49, 1375, 10.1111/j.1537-2995.2009.02152.x Liu, 1994, Prospective, randomized trial of the safety and efficacy of a limited donor exposure transfusion program for premature neonates., J Pediatr, 125, 92, 10.1016/S0022-3476(94)70132-6 Strauss, 2000, Feasibility and safety of AS-3 red blood cells for neonatal transfusions., J Pediatr, 136, 215, 10.1016/S0022-3476(00)70104-1 Walsh, 2004, Does the storage time of transfused red blood cells influence regional or global indexes of tissue oxygenation in anemic critically ill patients?, Crit Care Med, 32, 364, 10.1097/01.CCM.0000108878.23703.E0 Yürük, 2013, Transfusion of banked red blood cells and the effects on hemorrheology and microvascular hemodynamics in anemic hematology outpatients., Transfusion, 53, 1346, 10.1111/j.1537-2995.2012.03905.x Hébert, 2005, A pilot trial evaluating the clinical effects of prolonged storage of red cells., Anesth Analg, 100, 1433, 10.1213/01.ANE.0000148690.48803.27 Fergusson, 2012, Effect of fresh red blood cell transfusions on clinical outcomes in premature, very low-birth-weight infants: the ARIPI randomized trial., JAMA, 308, 1443, 10.1001/2012.jama.11953 Aubron, 2012, A pilot feasibility trial of allocation of freshest available red blood cells versus standard care in critically ill patients., Transfusion, 52, 1196, 10.1111/j.1537-2995.2011.03437.x Dhabangi, 2013, The effect of blood storage age on treatment of lactic acidosis by transfusion in children with severe malarial anaemia: a pilot, randomized, controlled trial., Malar J, 12, 55, 10.1186/1475-2875-12-55 Fernandes da Cunha, 2005, Transfusions of CPDA-1 red blood cells stored for up to 28 days decrease donor exposures in very low-birth-weight premature infants., Transfus Med, 15, 467, 10.1111/j.1365-3148.2005.00624.x Heddle, 2012, The effect of blood storage duration on in-hospital mortality: a randomized controlled pilot feasibility trial., Transfusion, 52, 1203, 10.1111/j.1537-2995.2011.03521.x Kor, 2012, Fresh red blood cell transfusion and short-term pulmonary, immunologic, and coagulation status: a randomized clinical trial., Am J Respir Crit Care Med, 185, 842, 10.1164/rccm.201107-1332OC Schulman, 2002, Impact of age of transfused blood in the trauma patient., J Trauma, 52, 1224, 10.1097/00005373-200206000-00036 Strauss, 1996, AS-1 red cells for neonatal transfusions: a randomized trial assessing donor exposure and safety., Transfusion, 36, 873, 10.1046/j.1537-2995.1996.361097017172.x Harm, 2012, Haemolysis and sublethal injury of RBCs after routine blood bank manipulations., Transfus Med, 22, 181, 10.1111/j.1365-3148.2011.01127.x Rother, 2005, The clinical sequelae of intravascular hemolysis and extracellular plasma hemoglobin: a novel mechanism of human disease., JAMA, 293, 1653, 10.1001/jama.293.13.1653 Prestia, 2014, Transfusion of stored blood impairs host defenses against Gram-negative pathogens in mice., Transfusion, 54, 2842, 10.1111/trf.12712 Carson, 2012, Red blood cell transfusion: a clinical practice guideline from the AABB*., Ann Intern Med, 157, 49, 10.7326/0003-4819-157-1-201206190-00429 Vamvakas, 2011, Purported deleterious effects of “old” versus “fresh” red blood cells: an updated meta-analysis., Transfusion, 51, 1122, 10.1111/j.1537-2995.2010.03017.x Patterson, 2015, Age of blood and adverse outcomes in a maternity population., Transfusion, 55, 2730, 10.1111/trf.13230 Cholette, 2015, Longer RBC storage duration is associated with increased postoperative infections in pediatric cardiac surgery., Pediatr Crit Care Med, 16, 227, 10.1097/PCC.0000000000000320 Brown, 2014, Length of red cell unit storage and risk for delirium after cardiac surgery., Anesth Analg, 119, 242, 10.1213/ANE.0000000000000134 van de Watering, 2013, Age of blood: does older blood yield poorer outcomes?, Curr Opin Hematol, 20, 526, 10.1097/MOH.0b013e328365aa3a Damiani, 2015, Plasma free hemoglobin and microcirculatory response to fresh or old blood transfusions in sepsis., PLoS One, 10, 10.1371/journal.pone.0122655 Lelubre, 2013, Relationship between red cell storage duration and outcomes in adults receiving red cell transfusions: a systematic review., Crit Care, 17, R66, 10.1186/cc12600 INFORM BioMed Central. ISRCTN Registry. Available at: http://www.controlled-trials.com/ISRCTN08118744. Accessed on August 22, 2015 ClinicalTrials.gov Available at: https://clinicaltrials.gov/. Accessed on August 22, 2015
Thông tin
Thông tin xuất bản

Blood

Tập 127

400-410

Thông tin tác giả